One of the major impacts of the current COVID-19 pandemic is the immense strain that is being put on the intensive care units. As a typical SARS-CoV-2 infection often leads to severe acute respiratory syndromes, one of the most basic essential examinations is lung auscultation. There are different categories of lung sounds that can be assessed with a stethoscope like crackles, wheezes, rhonchi and coarse breath sounds. Each of these malicious lung sounds contribute to a clinical assessment and follow-up of the patient's airways and lungs and can indicate the development of pneumonia. Therefore, auscultation on a regular basis is essential, but it also takes a lot of time for the physicians. Moreover, because of the risk of infection for health care workers, it is becoming increasingly difficult or sometimes impossible to safely use a stethoscope. Here we introduce a remote stethoscope system that can help to reduce the workload of physicians and nurses, diminishes the risk of contamination and leads to more standardized auscultation, which can also be stored and reevaluated. We provide a detailed description of our system, which consists of parts that are low cost, easily available in most parts of the world, or can be 3D printed. We provide instructions and an open source software stack to run such a system for a large number of patients which can be remotely auscultated from a central computer. We believe that the system described in this paper can allow various institutes to replicate the system, and increase the safety and reduce the overall workload in the intensive care units around the world.

The authors have declared no competing interest.

The work was sponsored by Flanders Make VZW, Non-Profit Strategic Research Institute, Oude Diestersebaan 133, 3920 Lommel, Belgium.

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Ethics Committee of University Hospital Antwerp (UZA/UAntwerp) gave Ethical Approval for this work under number B3002020000070 The Ethics Committee of UZA/UAntwerp is a fully recognized ethics committee in accordance with the law. Its operations, composition, and responsibilities are legally established in accordance with: The Royal Decree of August 12, 1994 The European Directive 2001/20 The Law of May 7, 2004, concerning Experiments on the Human Person: Articles 11, 11/1, and 11/2, as amended by the Law of March 19, 2013 Circular No. 613 of the FAMHP (Federal Agency for Medicines and Health Products) The study was approved by the central ethics committee of UZA.

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