Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests

Gwenllian Rhys; Tara Wakeling; Jonathan Moore; Chris Subbe

doi:10.1136/bmjopen-2022-068169

Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests

Gwenllian Rhys, Tara Wakeling, Jonathan Moore, Chris Subbe

Ysbyty Gwynedd

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVES: We aimed to identify exercise tests that have been validated to support a safe discharge to home in patients with or without COVID-19.

STUDY DESIGN: Scoping review, using PRISMA-ScR reporting standards. Medline, PubMed, AMED, Embase, CINAHL and LitCovid databases were searched between 16 and 22 February 2021, with studies included from any publication date up to and including the search date.

INTERVENTION: Short exercise tests.

PRIMARY OUTCOME MEASURES: Safe discharge from hospital, readmission rate, length of hospital stay, mortality. Secondary outcomes measures: safety, feasibility and reliability.

RESULTS: Of 1612 original records screened, 19 studies were included in the analysis. These used a variety of exercise tests in patients with chronic obstructive pulmonary disease, suspected pulmonary embolism and pneumocystis carinii pneumonia, heart failure or critical illness. Only six studies had examined patients with COVID-19, of these two were still recruiting to evaluate the 1 min sit-to-stand test and the 40-steps test. There was heterogeneity in patient populations, tests used and outcome measures. Few exercise tests have been validated to support discharge decisions. There is currently no support for short exercise tests for triage of care in patients with COVID-19.

CONCLUSIONS: Further research is needed to aid clinical decision-making at discharge from hospital.

Original language	English
Article number	e068169
Journal	BMJ Open
Volume	13
Issue number	10
Early online date	31 Oct 2023
DOIs	https://doi.org/10.1136/bmjopen-2022-068169
Publication status	Published - 31 Oct 2023

Keywords

Exercise Test
COVID-19
Acute care

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmjopen-2022-068169Licence: CC BY-NC

e068169.fullFinal published version, 450 KBLicence: CC BY-NC

Exercise testing in the acute setting – the utility of exercise testing to predict safe discharge in acute cardiopulmonary disease including validation of the 40 steps desaturation test in the assessment of acute or suspected COVID-19
Rhys, G. (Author), Macdonald, J. (Supervisor), Moore, J. (Supervisor) & Subbe, C. (Supervisor), 31 Oct 2022
Student thesis: Masters by Research

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title = "Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests",

abstract = "OBJECTIVES: We aimed to identify exercise tests that have been validated to support a safe discharge to home in patients with or without COVID-19.STUDY DESIGN: Scoping review, using PRISMA-ScR reporting standards. Medline, PubMed, AMED, Embase, CINAHL and LitCovid databases were searched between 16 and 22 February 2021, with studies included from any publication date up to and including the search date.INTERVENTION: Short exercise tests.PRIMARY OUTCOME MEASURES: Safe discharge from hospital, readmission rate, length of hospital stay, mortality. Secondary outcomes measures: safety, feasibility and reliability.RESULTS: Of 1612 original records screened, 19 studies were included in the analysis. These used a variety of exercise tests in patients with chronic obstructive pulmonary disease, suspected pulmonary embolism and pneumocystis carinii pneumonia, heart failure or critical illness. Only six studies had examined patients with COVID-19, of these two were still recruiting to evaluate the 1 min sit-to-stand test and the 40-steps test. There was heterogeneity in patient populations, tests used and outcome measures. Few exercise tests have been validated to support discharge decisions. There is currently no support for short exercise tests for triage of care in patients with COVID-19.CONCLUSIONS: Further research is needed to aid clinical decision-making at discharge from hospital.",

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N2 - OBJECTIVES: We aimed to identify exercise tests that have been validated to support a safe discharge to home in patients with or without COVID-19.STUDY DESIGN: Scoping review, using PRISMA-ScR reporting standards. Medline, PubMed, AMED, Embase, CINAHL and LitCovid databases were searched between 16 and 22 February 2021, with studies included from any publication date up to and including the search date.INTERVENTION: Short exercise tests.PRIMARY OUTCOME MEASURES: Safe discharge from hospital, readmission rate, length of hospital stay, mortality. Secondary outcomes measures: safety, feasibility and reliability.RESULTS: Of 1612 original records screened, 19 studies were included in the analysis. These used a variety of exercise tests in patients with chronic obstructive pulmonary disease, suspected pulmonary embolism and pneumocystis carinii pneumonia, heart failure or critical illness. Only six studies had examined patients with COVID-19, of these two were still recruiting to evaluate the 1 min sit-to-stand test and the 40-steps test. There was heterogeneity in patient populations, tests used and outcome measures. Few exercise tests have been validated to support discharge decisions. There is currently no support for short exercise tests for triage of care in patients with COVID-19.CONCLUSIONS: Further research is needed to aid clinical decision-making at discharge from hospital.

AB - OBJECTIVES: We aimed to identify exercise tests that have been validated to support a safe discharge to home in patients with or without COVID-19.STUDY DESIGN: Scoping review, using PRISMA-ScR reporting standards. Medline, PubMed, AMED, Embase, CINAHL and LitCovid databases were searched between 16 and 22 February 2021, with studies included from any publication date up to and including the search date.INTERVENTION: Short exercise tests.PRIMARY OUTCOME MEASURES: Safe discharge from hospital, readmission rate, length of hospital stay, mortality. Secondary outcomes measures: safety, feasibility and reliability.RESULTS: Of 1612 original records screened, 19 studies were included in the analysis. These used a variety of exercise tests in patients with chronic obstructive pulmonary disease, suspected pulmonary embolism and pneumocystis carinii pneumonia, heart failure or critical illness. Only six studies had examined patients with COVID-19, of these two were still recruiting to evaluate the 1 min sit-to-stand test and the 40-steps test. There was heterogeneity in patient populations, tests used and outcome measures. Few exercise tests have been validated to support discharge decisions. There is currently no support for short exercise tests for triage of care in patients with COVID-19.CONCLUSIONS: Further research is needed to aid clinical decision-making at discharge from hospital.

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KW - Acute care

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Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests

Abstract

Keywords

UN SDGs

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Exercise testing in the acute setting – the utility of exercise testing to predict safe discharge in acute cardiopulmonary disease including validation of the 40 steps desaturation test in the assessment of acute or suspected COVID-19

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