TY - JOUR

T1 - Feasibility and accuracy of the 40-steps desaturation test to determine outcomes in a cohort of patients presenting to hospital with and without COVID-19

AU - Rhys, Gwenllian Haf

AU - Wakeling, Tara

AU - Moosavi, Shakeeb

AU - Moore, Jonathan

AU - Dawes, Helen

AU - Knight, Matthew

AU - Inada-Kim, Matthew

AU - Frischknecht-Johansen, Erika

AU - Subbe, Chris

N1 - © Royal College of Physicians 2022. All rights reserved.

PY - 2022/5

Y1 - 2022/5

N2 - Desaturation on exercise has been suggested as a predictive feature for deterioration in COVID-19. The objective of this paper was to determine the feasibility and validity for the 40-steps desaturation test.A prospective observational cohort study was undertaken in patients assessed in hospital prior to discharge. One-hundred and fifty-two participants were screened between November 2020 and February 2021, and 64 were recruited to perform a 40-steps desaturation test. Patients who were able to perform the test were younger and less frail. Four patients were readmitted to hospitaland one patient deteriorated within 30 days but no patient died.The majority of patients showed little change in saturations during the test, even with pre-existing respiratory pathology. Change in saturations, respiratory rate, heart rate and breathlessness were not predictive of death or readmission to hospital within 30 days. Of 13 patients who had a desaturation of 3% or more during exercise, none was readmitted to hospital within 30 days. Not enough patients with COVID-19 could be recruited to the study to provide evidence for the safety of the test in this patient group. The 40-steps desaturation test requires further evaluation to assess clinical utility.

AB - Desaturation on exercise has been suggested as a predictive feature for deterioration in COVID-19. The objective of this paper was to determine the feasibility and validity for the 40-steps desaturation test.A prospective observational cohort study was undertaken in patients assessed in hospital prior to discharge. One-hundred and fifty-two participants were screened between November 2020 and February 2021, and 64 were recruited to perform a 40-steps desaturation test. Patients who were able to perform the test were younger and less frail. Four patients were readmitted to hospitaland one patient deteriorated within 30 days but no patient died.The majority of patients showed little change in saturations during the test, even with pre-existing respiratory pathology. Change in saturations, respiratory rate, heart rate and breathlessness were not predictive of death or readmission to hospital within 30 days. Of 13 patients who had a desaturation of 3% or more during exercise, none was readmitted to hospital within 30 days. Not enough patients with COVID-19 could be recruited to the study to provide evidence for the safety of the test in this patient group. The 40-steps desaturation test requires further evaluation to assess clinical utility.

KW - Covid-19

KW - desaturation

KW - Exercise test

KW - 40-steps test

U2 - 10.7861/clinmed.2022-0027

DO - 10.7861/clinmed.2022-0027

M3 - Article

C2 - 35443969

VL - 22

SP - 203

EP - 209

JO - Clinical Medicine

JF - Clinical Medicine

SN - 1470-2118

IS - 3

M1 - 0027

ER -