*4.3. Telemedicine as a Proposed Strategy against SARS-CoV-2*

One of the proposed strategies providing clinical healthcare and information regarding measurements, control, and protection against SARS-CoV-2 during the prevailing COVID-19 pandemic is telemedicine. With this strategy, patients who need care for anxiety caused by COVID-19 infection can be assisted without the requirement for visiting a hospital, and therapy for psychological stabilization can be provided via the internet, without the need for an in-person consultation with the doctor. According to our study, patients suffering from coronary heart disease (*p* < 0.001, Table S1), asthma (*p* = 0.026, Table S1), COPD (*p* < 0001, Table S1), and heart failure (*p* < 0.001, Table S1), patients vaccinated against influenza in 2019 (*p* < 0.001, Figure 1A, Table S1) and in 2020 (*p* = 0.008, Table S1), patients being on multi-drug therapy (*p* < 0.001, Table S1), and patients exhibiting the reluctance to carry out more complex daily activities (IADL scale, *p* < 0.001, Figure 1B, Table S1), with a higher level of anxiety (*p* = 0.002, Table S1), social loneliness (*p* = 0.004, Table S1) and malnutrition (*p* < 0.001, Table S1), canceled planned hospitalizations due to the fear of COVID-19 infection. Thus, these groups of elderly patients require more attention, and hence telemedicine should be focused mostly on them. This strategy provides an alternative avenue to provide medical education for COVID-19 infected patients and avoid unnecessary mortality [49].

Due to the prevailing pandemic, numerous new platforms are projected to grow exponentially, allowing the older population to achieve sufficient knowledge to introduce precautionary measures against COVID-19 to protect themselves, their families, and the whole population while maintaining perfect harmony and peace of mind [50]. The positive effects of telemedicine providing psychological consultation, progress in educating patients as well as healthcare have been verified in many previous studies [50–52]. In one study, Tourkmani et al. found a significant positive effect of telemedicine care among high-risk patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia [53]. Furthermore, Nan et al. proposed a telemedicine-based protocol to manage patients with ST-segment elevation myocardial infarction during the COVID-19 pandemic. Authors suggested that wearable medical devices with the proposed application can provide additional patient information, including heart rate, body weight, blood pressure, and others, that may be useful for doctors to make better decisions for their patients, especially when social distancing is necessary [37]. Thus, we believe that the reduction of activity during the pandemic is, in many cases, favorable and might possibly

reduce the number of COVID-19-related complications and mortality, particularly in the susceptible, older population. However, it is worth noticing that physical and social activity is notably essential and beneficial in the senior population [18–20]. Another practical solution to utilize telemedicine more efficiently was proposed by Tolone et al. [54]. The authors proposed a simple and reproducible telephonic triage questionnaire that might be applicable before readmission of patients to hospitals for elective surgery to avoid unnecessary visits to the hospital and reduce healthcare costs and in-hospital positivity. We think that telemedicine's development in common with a continuous process of education and the process of vaccination against the SARS-CoV-2 virus would allow achieving a balance between cautious behavior and social, recreative, and professional activity. Moreover, it would facilitate a process of constant treatment of life-limiting and lifethreatening comorbidities. We believe that such a proceeding could significantly impact patients' quality of life and economic and medical issues.
