Impacto e futuro da telemedicina em meio à pandemia de COVID-19: uma revisão sistemática do estado da arte na América Latina

Nieblas, Bianca; Okoye, Kingsley; Carrión, Belinda; Mehta, Neil; Mehta, Seysha

Bianca Nieblas

Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey. 64849 Monterrey NL México. bca@tec.mx

http://orcid.org/0000-0002-8513-6163

Kingsley Okoye

Writing Lab, Institute for Future of Education, Office of the Vice President and Technology Transfer, Tecnológico de Monterrey. 64849 Monterrey NL México. kingsley.okoye@tec.mx

http://orcid.org/0000-0002-6943-9885

Belinda Carrión

Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey. 64849 Monterrey NL México. bca@tec.mx

http://orcid.org/0000-0002-4245-1139

Neil Mehta

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University. Cleveland OH United States.

http://orcid.org/0000-0001-8342-4252

Seysha Mehta

Dartmouth College. Hanover NH United States.

http://orcid.org/0000-0001-5411-1628

Collaborations

B Nieblas: conceptualization; data curation; formal and review analysis; investigation; software; validation; discussion, writing - original draft; writing - review and editing. K Okoye: conceptualization; data curation; formal and review analysis; investigation; methodology; software; validation; discussion, writing - original draft; writing - review and editing; correspondence. B Carrión: conceptualization; data curation; formal and review analysis; investigation; validation; discussion, writing - original draft; writing - review and editing; correspondence. N Mehta and S Mehta: data curation; investigation; discussion; writing - review and editing.

Chief editors:

Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Authors	Year	Country	Method/tool Used or Proposed	Findings/main contribution	Domain/area of application	Scope related to research question	Method applicable to research objective	Source/DOI
Montenegro et al.³³33 Montenegro P, Pinillos L, Young F, Aguilar A, Tirado-Hurtado I, Pinto JA, Vallejos C. Telemedicine and the current opportunities for the management of oncological patients in Peru in the context of COVID-19 pandemic. Crit Rev Oncol Hematol 2021; 157:103129.	2021	Peru	Survey of experience and workflow in telemedicine	impact of telemedicine amidst the COVID-19 (case study of Peru)	COVID-19, Cancer, Telehealth, Telemedicine, Patient management	Yes	Yes	https://doi.org/10.1016/j.critrevonc.2020.103129
Silberman et al.³⁴34 Silberman P, López E, Medina A, Díaz Bazán JM, Gómez Marquisio MD, López GA. Tele-revistas en unidades de terapia intensiva: coordinación asistencial y aprendizaje en el marco de la pandemia. Rev Argent Salud Publica 2020; 12(Suplemento Covid-19):1-5.	2020	Argentina	Tele-Magazines in ICU (TR-ICU) applied to optimize the care of patients with COVID -19 hospitalized in serious condition	describe the process and results of the first 50 days of the TR-ICU implementation	COVID-19, UTI	Yes	Yes	http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1853-810X2020000300006⟨=en
Cabrera et al.³⁵35 Cabrera-Vargas LF, Luna Jaspe C, Pedraza Ciro M. Adaptación de la residencia de cirugía general en Colombia a la pandemia del COVID-19: programa de enseñanza quirúrgica virtual. Rev Colomb Cirugia 2020; 35(2):257-264.	2020	Colombia	Virtual surgical teaching project	Innovative approach to surgery residents	COVID-19, Surgery, Education	Yes	Yes	https://doi.org/10.30944/ 20117582.632
Melo Maciel et al.³⁶36 Maciel FBM, Santos HLPC, Carneiro RAS, Souza EA, Prado NMBL, Teixeira CFS. Agente comunitário de saúde: reflexões sobre o processo de trabalho em saúde em tempos de pandemia de Covid-19. Cien Saude Colet 2020; 25(Suppl. 2):4185-4195.	2020	Brasil	Review regarding key aspects that include the use of telehealth based on analysis of premises of primary health care on the axes of CHW work	This study concluded that the Covid-19 pandemic demanded reorganization of the work processes and assistance flows in the field of basic care	COVID-19, Primary Health Care	Yes	Yes	https://doi.org/10.1590/ 1413-812320202510. 2.28102020
Capoulade & Pereira³⁷37 Capoulade F, Pereira MEC. Desafios colocados para a clínica psicanalítica (e seu futuro) no contexto da pandemia de COVID-19. Reflexões a partir de uma experiência clínica. Rev Latinoam Psicopatol Fundam 2020; 23(3):534-548.	2020	Brasil	Implementation of a psychoanalytic care service with virtual support in nascent context of the COVID-19 pandemic and the issues arising from this experience	-	COVID-19, Psychology	Yes	Yes	https://doi.org/10.1590/1415-4714.2020v23n3p534.6
Valdez-García et al.³⁸38 Valdez-García JE, López Cabrera MV, Jiménez Martínez MA, Díaz Elizondo JA, Dávila Rivas JAG, Olivares Olivares SL. Me preparo para ayudar: respuesta de escuelas de medicina y ciencias de la salud ante COVID-19. Investig en Educ Médica 2020; 9(35):85-95.	2020	Mexico	Proposal of a model of guidelines as an action plan in the face of the expansion of COVID-19.	Proposes some guideline as an action plan to face the expansion of COVID-19 that includes the use of telemedicine	COVID-19, Education	Yes	Yes	https://doi.org/10.22201/ facmed.20075057e. 2020.35.20230
Peres et al.¹⁵15 Peres KG, Reher P, Castro RD, Vieira AR. COVID-19-related challenges in dental education: experiences from Brazil, the USA, and Australia. Pesqui Bras em Odontopediatria e Clínica Integr 2020; 20(Suppl. 1):e0131.	2020	Brasil	Descriptive study reporting experiences that three distinct dental schools (one of them in Brazil) faced during the COVID-19 pandemic	Proposes the need to review clinical practices, e.g., iosafety and be forever, stimulated to try new ways to teach to the next generation of dentists	COVID-19, Education	Yes	Yes	https://doi.org/10.1590/pboci.2020.130
Denadai³⁹39 Denadai R. COVID-19 pandemic as a driver for spreading virtual care globally: the future starts now. Clinics (Sao Paulo) 2020; 75:e1967.	2020	Brasil	Comment on the advantages of using telemedicine and the need to break down barriers once the pandemic is over	Suggests that standard of care may change compared to the pre-pandemic standard, expects that barriers restraining the widespread use of telemedicine can also be overcome	COVID-19, Telehealth	Yes	Yes	https://dx.doi.org/10.6061%2Fclinics%2F2020%2Fe1967
Galindo Neto et al.⁴⁰40 Galindo Neto NM, Sá GGM, Barbosa LU, Pereira JCN, Henriques AHB, Barros LM. COVID-19 and digital technology: mobile applications available for download in smartphones. Texto Context - Enferm 2020; 29:e20200150.	2020	Brasil	cross-sectional study that included 52 mobile applications on COVID-19	Association between target audience and the subtheme of symptoms, prevention, and care, and between patient monitoring and professional training	COVID-19, Telehealth, mobile apps	Yes	Yes	https://doi.org/10.1590/1980-265x-tce-2020-0150
Sampaio Florêncio et al.⁴¹41 Florêncio RS, Feitosa Cestari VR, Souza LC, Flor AC, Nogueira VP, Moreira TMM, Salvetti MG, Pessoa VLMP. Palliative care amidst the COVID-19 pandemic: Challenges and contributions. ACTA Paul Enferm 2020; 33:eAPE20200188.	2020	Brasil	Literature review on the incorporation of palliative care in scenario of the COVID-19 pandemic	Strategies for implementation of palliative care with use of protocols and telemedicine to facilitate communication	COVID-19, Telehealth, palliative care	Yes	Yes	https://doi.org/10.37689/acta-ape/2020ao01886
Carlos et al.⁴²42 Carlos DM, Wernet M, Okido ACC, Oliveira WA, Silveira AO, Costa LCR. The dialogical experience of being a mother of a child and a nurse in the COVID-19 Pandemic. Texto Context - Enferm. 2020;29:e20200329.	2020	Brasil	Semi-structured interviews conducted via an open access virtual communication platform.	Indicates the need for structural institutional policies for equality and safety in the medical profession and a healthy intra-family relationship, e.g., for mother-nurses	COVID-19, Telehealth, Nursing	Yes	Yes	https://doi.org/10.1590/1980-265x-tce-2020-0329
Vasquez et al.⁸8 Vasquez L, Sampor C, Villanueva G, Maradiegue E, Garcia-Lombardi M, Gomez-García W, Moreno F, Diaz R, Cappellano AM, Portilla CA, Salas B, Nava E, Brizuela S, Jimenez S, Espinoza X, Gassant PY, Quintero K, Fuentes-Alabi S, Velasquez T, Fu L, Gamboa Y, Quintana J, Castiglioni M, Nuñez C, Moreno A, Luna-Fineman S, Luciani S, Chantada G. Early impact of the COVID-19 pandemic on paediatric cancer care in Latin America. Lancet Oncol 2020; 21(6):753-755.	2020	Peru	Cross-sectional survey of paediatric onco-haematologists in April 12-19, 2020.	Large coverage that helped examine the potential impact of COVID-19 on the management of children with cancer in Latin America	COVID-19, pediatric oncology	Yes	Yes	https://doi.org/10.1016/S1470-2045(20)30280-1
Schmulson et al.⁴³43 Schmulson M, Gudiño-Zayas M, Hani A. The impact of COVID-19 pandemic on neurogastroenterologists in Latin America: results of an online survey. J Clin Gastroenterol 2020; 55(8):684-690.	2020	Mexico	Online anonymous survey on demographics, clinical practice and procedure characteristics, impact of the pandemic, Telemedicine, and involvement in COVID-19 patient care	Negative impact of the pandemic on neurogastroenterology practice, e.g., lack of remunerated practice by telemedicine	COVID-19, Neurogastroenterology	Yes	Yes	https://doi.org/10.1097/mcg.0000000000001413
Schinköthe et al.¹⁸18 Schinköthe T, Gabri MR, Mitterer M, Gouveia P, Heinemann V, Harbeck N, Subklewe M. A web- And app-based connected care solution for COVID-19 in- and outpatient care: qualitative study and application development. JMIR Public Heal Surveill 2020; 6(2):e19033.	2020	Argentina	Unstructured interviews recollected from physicians around the world including Argentina which explained challenges with COVID-19 patient care	Physicians identified a number of different scenarios where telemedicine or the connected care solutions could rapidly improve patient care	COVID-19, Telehealth	Yes	Yes	https://doi.org/10.2196/19033
Trujillo et al.⁴⁴44 Jarry Trujillo C, Achurra Tirado P, Escalona Vivas G, Crovari Eulufi F, Varas Cohen J. Surgical training during COVID-19: a validated solution to keep on practicing. Br J Surg 2020; 107(11):e468-e469.	2020	Chile	LAPP methodology. Laparoscopy feedback.	Demonstrated effective transfer of skills from a validated surgical instruction program	COVID-19, TeleEducation	Yes	Maybe	https://doi.org/10.1002/bjs.11923
Sánchez et al.⁴⁵45 Soriano Sánchez JA, Perilla Cepeda TA, Zenteno M, Campero A, Yampolsky C, Varela ML, Soto García ME, Romero Rangel JAI. Early report on the impact of COVID-19 outbreak in neurosurgical practice among members of the Latin American Federation of Neurosurgical Societies. World Neurosurg 2020; 140: e195-e202.	2020	Mexico	Internet-based survey among presidents and members of the societies of The Latin American Federation of Neurosurgical Societies	Reported having suspended regular activities and local congresses, due to mandatory isolation by government, although telemedicine Projects were instituted	COVID-19. TeleHealth	Yes	Yes	https://doi.org/10.1016/j.wneu.2020.04.226
Saenz et al.⁴⁶46 Saenz LC, Miranda A, Speranza R, Texeira RA, Rojel U, Enriquez A, Figuereido M. Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic: Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC). J Interv Card Electrophysiol 2020; 59(2):307-313.	2020	Colombia	Establish guidelines towards attending to patients in electrophysiological unit	Recommended transitioning to virtual consultation (via telephone or video) for majority of first assessments and/or follow-ups during the COVID-19 pandemic	Covid-19, TeleHealth	Yes	Yes	https://doi.org/10.1007/s10840-020-00747-5
Yokoo et al.⁴⁷47 Yokoo P, Silva MCBD, Castro ADAE, Fonseca EKUN, Martins KM, Queiroz MRG, Szarf G, Tachibana A. Quality and safety innovations in the Radiology Department during the COVID-19 pandemic: a Latin American experience. Einstein (Sao Paulo) 2020; 18:eGS5832.	2020	Brasil	Describe a Radiology Department’s policies in a private hospital in preparedness to the coronavirus disease	Provides useful information and examples of innovations that can help other radiology departments	Covid-19, TeleHealth, Radiology	yes	yes	https://doi.org/10.31744/einstein_journal/2020gs5832
Sorbara et al.⁴⁸48 Sorbara M, Graviotto HG, Lage-Ruiz GM, Turizo-Rodriguez CM, Sotelo-López LA, Serra A, Gagliardi C, Heinemann G, Martinez P, Ces-Magliano F, Serrano CM. COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina. Neurol (English Ed) 2021; 36(1):9-15.	2020	Argentina	Descriptive, observational, and cross-sectional study based on data collected through an online survey	50% of respondents had sought medical consultation by electronic means	COVID-19, Mental health	Yes	Yes	https://doi.org/10.1016/j.nrleng.2020.07.014
Sadler et al.⁴⁹49 Sadler D, DeCara JM, Herrmann J, Arnold A, Ghosh AK, Abdel-Qadir H, Yang EH, Szmit S, Akhter N, Leja M, Silva CMPDC, Raikhelkar J, Brown SA, Dent S, O'Quinn R, Thuny F, Moudgil R, Raez LE, Okwuosa T, Daniele A, Bauer B, Kondapalli L, Ismail-Khan R, Lax J, Blaes A, Nahleh Z, Elson L, Baldassarre LA, Zaha V, Rao V, Lara DS, Skurka K, Cardio-Oncology International Collaborative Network. Perspectives on the COVID-19 pandemic impact on cardio-oncology: results from the COVID-19 International Collaborative Network survey. Cardio-Oncology 2020; 6(1):28.	2020	Brasil	Electronic survey by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology, American Society of Clinical Oncology, and International Cardio-Oncology Society	Propose initiatives to promote expanded coverage for telemedicine, increased access to PPE and medical professional in preparedness for future health care crisis	COVID-19, cardio-oncology	Yes	Yes	https://doi.org/10.1186/s40959-020-00085-5
Rodriguez et al.⁵⁰50 Rodriguez J, Fletcher A, Heredia F, Fernandez R, Ramírez Salazar H, Sanabria D, Burbano Luna J, Guerrero E, Pierre ME, Rendón GJ, Rosero I, Trujillo LM, Ribeiro R, Baiocchi G, Lopez Blanco A, Malca M, Hoegl J, Borges Garnica A, Lasso de la Vega J, Scasso S, Laufer J, Estrada EE, Gutierrez Criado A, Herbert Nuñez GS, Cantú-de Leon D, Medina G, Pendola Gómez L, Saadi J, Noll F, Arévalo Sandoval D, Ferreira Oliveira A, Pareja R. Alternative management for gynecological cancer care during the COVID-2019 pandemic: a Latin American survey. Int J Gynecol Obstet 2020; 150(3):368-378.	2020	Colombia	Electronic survey based on recommendations from international societies. Studied consultation care, preinvasive cervical pathology, and cervical, ovarian, and endometrial cancer	Respondents favored offering teleconsultation as triage for post-cancer treatment follow-up (94.6%)	COVID-19, Cancer, Telemedicine	Yes	Yes	https://doi.org/10.1002/ijgo.13272
Bunch et al.⁵¹51 Bunch A, Ardila F, Castaño R, Quiñonez S, Corzo L. Through the storm: automated peritoneal dialysis with remote patient monitoring during COVID-19 pandemic. Blood Purif 2020; 50(3):279-282.	2020	Colombia	Changes in standard care for renal patients	Home care for patients on APD with RPM program could be successfully implemented by increasing interaction between patient and the renal clinic staff	COVID-19, renal health	Yes	Yes	https://doi.org/10.1159/000511407
Salvalaggio et al.⁵²52 Salvalaggio PR, Ferreira GF, Caliskan Y, Vest LS, Schnitzler MA, de Sandes-Freitas TV, Moura LR, Lam NN, Maldonado RA, Loupy A, Axelrod DA, Lentine KL. An international survey on living kidney donation and transplant practices during the COVID-19 pandemic. Transpl Infect Dis 2020; 23(2):e13526.	2020	Brasil	Survey responses from 204 transplant centers, internationally, from May to June 2020 on impact of the COVID-19 pandemic towards living donor kidney transplantation (LDKT) practices.	For the centers that continued donor evaluations, 40% performed in-person visits, 68% by video, and 42% by telephone	COVID-19, renal health	Yes	Yes	https://doi.org/10.1111/tid.13526
Marquez-Velasquez²⁰20 Juan Ricardo Márquez V. Teleconsultation in a pandemic due to coronavirus: challenges for telemedicine in the post-COVID-19 era. Rev Colomb Gastroenterol 2020; 35(Supl. 1):5-16.	2020	Colombia	Design of a teleconsultation program	Revealed an execution rate of 94% and a resolution of 78%. Shows that telemedicine, like other telework-based activities, is here to stay and brings with it high levels of satisfaction for physicians	COVID-19, telehealth	Yes	Yes	https://doi.org/ 10.22516/25007440.543

Correlational study of the main findings and contribution of the analyzed studies
Frequency of words		Correlation of words
Term	Freq	Associated words with average probability (%)
Telemedicine	9	physicians	activities	care	amidst	facilitate
		0.39	0.39	0.31	0.27	0.27
Care	8	patient	connected	improve	solutions	monitoring
Care	8	0.68	0.63	0.63	0.63	0.25
COVID-19	5	impact	amidst	case	Latin America	consultation
COVID-19	5	0.43	0.41	0.41	0.41	0.22
Impact	3	amidst	Latin america	management	practice	COVID19
Impact	3	0.55	0.55	0.55	0.55	0.43
Patient	3	care	monitoring	prevention	improve	interaction
Patient	3	0.68	0.55	0.55	0.55	0.55

[1] Collaborations

B Nieblas: conceptualization; data curation; formal and review analysis; investigation; software; validation; discussion, writing - original draft; writing - review and editing. K Okoye: conceptualization; data curation; formal and review analysis; investigation; methodology; software; validation; discussion, writing - original draft; writing - review and editing; correspondence. B Carrión: conceptualization; data curation; formal and review analysis; investigation; validation; discussion, writing - original draft; writing - review and editing; correspondence. N Mehta and S Mehta: data curation; investigation; discussion; writing - review and editing.

Brasil

Brasil

Impacto e futuro da telemedicina em meio à pandemia de COVID-19: uma revisão sistemática do estado da arte na América Latina

Resumo