One minute sit-to-stand test as a potential triage marker in COVID-19 patients: A pilot observational study. (August 2021)

• Record Type: Journal Article
• Authors: Guha Niyogi, Subhrashis; Agarwal, Ritesh; Suri, Vikas; Malhotra, Pankaj; Jain, Divya; Puri, Goverdhan Dutt
• Is Part Of: Trends in anaesthesia and critical care. Volume 39(2021)
• Page Start: 5
• Page End: 9
• Publication Date: 2021-08
• Subjects: COVID 19 -- Exertional dyspnea -- Triage; Anesthesia -- Periodicals; Critical care medicine -- Periodicals; Anesthesia in traumatology -- Periodicals; Anesthesia -- Case studies -- Periodicals; 617.9605
• DOI: 10.1016/j.tacc.2021.04.007
• Languages: English
• ISSNs: 2210-8440

Abstract

Abstract: Background: The crisis of critical care resource allocation during the novel coronavirus infectious disease 2019 (COVID-19) pandemic has underscored the importance of triage. COVID-19 is associated with increased hypoxemia and desaturation on exertion. We hypothesized that desaturation after 1-min sit-to-stand test (1MSTS), a validated field exercise test can serve as a potential marker for triage of COVID 19 patients. Methods: Subjects with proven COVID 19 without hypoxemia on ambient air at presentation underwent the 1MSTS. The demographic details, clinical profile, pre and post-test vitals and pulse oximetric saturation was recorded and they were followed up for outcome throughout the hospital stay and after discharge. Results: 55 mild cases of COVID-19 and 6 cases of recovering severe COVID-19 were included. The mild cohort had a median age of 35 years (IQR, 27–41.5) and a median hospital stay of 16 days (IQR 14, 20). The severe cohort had a median age of 47.5 years (IQR, 42.3, 54.3) and median intensive care and hospital stays of respectively 9 (IQR, 7.5, 9) and 23.5 (IQR, 21.5, 27) days. The two cohorts showed median desaturations of 0% (IQR, 0.5–1) and 5.5% (IQR, 4.3–6) respectively. No subjects in the mild cohort needed oxygen therapy or escalation of care to intensive care. Conclusions: Significant desaturation after 1-MSTSin severe COVID 19 patients demonstrates the potential role of 1-MSTS both in triage for planning care and as a discharge criteria from intensive care unit. However, larger prospective studies are warranted for its evaluation and establishment of relevant cut-offs. Highlights: We hypothesized that desaturation after a the 1-min sit-to-stand test may be useful in triage of COVID patients as it requires lesser time, as well as space. We found that recovering subjects with severe COVID-19 show higher desaturation after the 1-min sit-to-stand test than mild cases. This warrants larger prospective evaluation.