Kumar Ankit, Hegde Naveen, Kumaravel J, Mohindra Ritin, Soni Roop Kishor, Rathod Ramya, Kumar Mohan, Muthu Valliappan, Gamad Nanda, Patil Amol N, Sharma P L
Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Family Med Prim Care. 2022 Nov;11(11):7008-7014. doi: 10.4103/jfmpc.jfmpc_1111_22. Epub 2022 Dec 16.
There has been a lack of uniformity on how to triage coronavirus disease 2019 (COVID-19) patients visiting the emergency units of hospitals. Triage tools are themselves spreading the pandemic in hospital areas. The present study compared a master two-step (M2ST) exercise stress test versus a 6-min walk test (6MWT) in COVID-19-positive patients visiting the emergency unit of a hospital.
Thirty-nine patients underwent 6MWT followed by M2ST, while another set of 38 patients underwent M2ST followed by 6MWT in this randomized, crossover, open-label, and noninferiority study. The exercise tests assessed the change from baseline in SpO, heart rate (HR), respiratory rate, blood pressure, exertion, and dyspnea on the modified-Borg scale.
Noninferiority was established for SpO ( < 0.05), systolic blood pressure (SBP; < 0.001), and diastolic blood pressure (DBP; < 0.05), but not for HR ( = 0.3) and respiratory rate ( = 0.6). The difference between the pretest and posttest (delta change) values for the parameters SpO, respiratory rate, HR, SBP, and DBP correlated significantly ( < 0.001) with Pearson correlation coefficient ( = 0.764, 0.783, 0.473, 0.838, and 0.783, respectively). The delta change values of modified-Borg scale for dyspnea ( = 0.291) and exertion ( = 0.208) were statistically insignificant between the two exercise tests. However, the correlation between the tests was statistically significant ( < 0.001).
M2ST, a timesaving, cost-effective, and easy to perform exercise stress test, has been identified as a reliable alternative for 6MWT.
对于前往医院急诊科的2019冠状病毒病（COVID-19）患者，在如何进行分诊方面缺乏统一标准。分诊工具本身正在医院区域传播这种大流行病。本研究比较了在一家医院急诊科就诊的COVID-19阳性患者中，主两步（M2ST）运动应激试验与6分钟步行试验（6MWT）。
在这项随机、交叉、开放标签且非劣效性研究中，39名患者先进行6MWT，然后进行M2ST，而另一组38名患者先进行M2ST，然后进行6MWT。运动试验评估了在改良Borg量表上，从基线开始的血氧饱和度（SpO）、心率（HR）、呼吸频率、血压、用力程度和呼吸困难的变化。
在SpO（<0.05）、收缩压（SBP；<0.001）和舒张压（DBP；<0.05）方面确立了非劣效性，但在HR（=0.3）和呼吸频率（=0.6）方面未确立。SpO、呼吸频率、HR、SBP和DBP参数的测试前与测试后（差值变化）值之间的差异与Pearson相关系数显著相关（<0.001）（分别为=0.764、0.783、0.473、0.838和0.783）。在两项运动试验之间，改良Borg量表上呼吸困难（=0.291）和用力程度（=0.208）的差值变化值无统计学意义。然而，两项试验之间的相关性具有统计学意义（<0.001）。
M2ST是一种省时、经济高效且易于实施的运动应激试验，已被确定为6MWT的可靠替代方法。
