The procedures and methods of this study will be made available for replication upon reasonable request directed to the corresponding author. The Institutional Review Board of Universidade Federal de Minas Gerais approved the study under CAAE number 37228120.9.0000.5149.
This is a comparative observational study with prospective data collection. The sample consisted of two arms and one parallel registry, and clinical and electrocardiographic outcomes were assessed remotely. The project was funded by the Brazilian Ministry of Health and conducted by the Telehealth Center of Hospital das Clínicas, Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). Remote data collection occurred in health units connected to the Teleassistance Network of Minas Gerais (Rede de Teleassistência de Minas Gerais–RTMG), and the tele-electrocardiography (ECG) system for COVID-19, in all Brazilian regions.
During the COVID-19 pandemic, RTMG adapted its mobile ECG application to provide clinical decision support for COVID-19 cases in health units, especially in primary care, with demographic and clinical data collection, and ECGs for remote interpretation. It was recommended by health authorities that an ECG be obtained before and following the initiation of drugs for COVID-19. ECGs were captured by commercial equipment linked to specific proprietary software, which allows for getting the ECG signal and clinical data, and transmitted by internet to a central server at the Telehealth Center. The requesting healthcare provider collected baseline history, demographic and clinical data. ECGs were centrally analyzed by a team of experienced cardiologists, utilizing specific semi-automated software with measurement and magnification tools, with visual inspection and subsequent classification by the Minnesota code. Minnesota is the most widely used ECG classification system in the world, developed in the 1950s by Dr. Henry Blackburn, which utilizes a defined set of measurement rules to assign specific numerical codes according to the severity of findings (16 (link), 17 (link)). In the presence of a discrepancy between automated reports and the cardiologist’s interpretation, exams were audited by the study team, composed of three previously trained investigators. All ECGs of patients with suspected COVID-19 in the study period were eligible for this analysis and stored in a specific database.
This is a comparative observational study with prospective data collection. The sample consisted of two arms and one parallel registry, and clinical and electrocardiographic outcomes were assessed remotely. The project was funded by the Brazilian Ministry of Health and conducted by the Telehealth Center of Hospital das Clínicas, Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). Remote data collection occurred in health units connected to the Teleassistance Network of Minas Gerais (Rede de Teleassistência de Minas Gerais–RTMG), and the tele-electrocardiography (ECG) system for COVID-19, in all Brazilian regions.
During the COVID-19 pandemic, RTMG adapted its mobile ECG application to provide clinical decision support for COVID-19 cases in health units, especially in primary care, with demographic and clinical data collection, and ECGs for remote interpretation. It was recommended by health authorities that an ECG be obtained before and following the initiation of drugs for COVID-19. ECGs were captured by commercial equipment linked to specific proprietary software, which allows for getting the ECG signal and clinical data, and transmitted by internet to a central server at the Telehealth Center. The requesting healthcare provider collected baseline history, demographic and clinical data. ECGs were centrally analyzed by a team of experienced cardiologists, utilizing specific semi-automated software with measurement and magnification tools, with visual inspection and subsequent classification by the Minnesota code. Minnesota is the most widely used ECG classification system in the world, developed in the 1950s by Dr. Henry Blackburn, which utilizes a defined set of measurement rules to assign specific numerical codes according to the severity of findings (16 (link), 17 (link)). In the presence of a discrepancy between automated reports and the cardiologist’s interpretation, exams were audited by the study team, composed of three previously trained investigators. All ECGs of patients with suspected COVID-19 in the study period were eligible for this analysis and stored in a specific database.
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