Ysbyty Gwynedd, Bangor, UK.
Oxford Brookes University, Oxford, UK.
Clin Med (Lond). 2022 May;22(3):203-209. doi: 10.7861/clinmed.2022-0027. Epub 2022 Apr 20.
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.
运动时血氧饱和度下降被认为是 COVID-19 恶化的预测特征。本文旨在确定 40 步血氧饱和度下降测试的可行性和有效性。
这是一项前瞻性观察队列研究，在出院前评估的患者中进行。2020 年 11 月至 2021 年 2 月期间对 152 名患者进行了筛查，招募了 64 名患者进行 40 步血氧饱和度下降测试。能够进行测试的患者更年轻，身体更健壮。有 4 名患者住院，1 名患者在 30 天内病情恶化，但无患者死亡。
大多数患者在测试过程中血氧饱和度变化不大，即使存在先前存在的呼吸病理学。血氧饱和度、呼吸频率、心率和呼吸困难的变化不能预测 30 天内死亡或再次住院。在 13 名运动时血氧饱和度下降 3%或以上的患者中，无一人在 30 天内再次住院。
由于 COVID-19 患者招募不足，无法为该患者组提供该测试安全性的证据。40 步血氧饱和度下降测试需要进一步评估，以评估其临床效用。
