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

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 pr...

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Bibliographic Details
Published in:Clinical medicine (London, England) England), 2022-05, Vol.22 (3), p.203-209
Main Authors: Rhys, Gwenllian Haf, Wakeling, Tara, Moosavi, Shakeeb H, Moore, Jonathan P, Dawes, Helen, Knight, Matthew, Inada-Kim, Matt, Christensen, Erika F, Subbe, Christian P
Format: Article
Language:English
Subjects:
40-steps test
Age
Asthma
Chronic obstructive pulmonary disease
Coronaviruses
COVID-19
Data analysis
desaturation
Dyspnea
exercise test
Heart failure
Heart rate
Hospitals
Medical research
Original Research
Patients
Physiology
Severe acute respiratory syndrome coronavirus 2
Walking
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Summary: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 hospital and 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.
ISSN:1470-2118
1473-4893
DOI:10.7861/clinmed.2022-0027