Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests
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In: BMJ Open, Vol. 13, No. 10, e068169, 31.10.2023.
Research output: Contribution to journal › Article › peer-review
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T1 - Exercise testing to guide safe discharge from hospital in COVID-19: a scoping review to identify candidate tests
AU - Rhys, Gwenllian
AU - Wakeling, Tara
AU - Moore, Jonathan
AU - Subbe, Chris
N1 - © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/10/31
Y1 - 2023/10/31
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.
KW - Exercise Test
KW - COVID-19
KW - Acute care
U2 - 10.1136/bmjopen-2022-068169
DO - 10.1136/bmjopen-2022-068169
M3 - Article
C2 - 37907292
VL - 13
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 10
M1 - e068169
ER -