One Minute Sit-to-Stand test as a potential Triage marker in COVID-19 patients: A Pilot Observational Study

Niyogi, Subhrashis Guha; Agarwal, Ritesh; Suri, Vikas; Malhotra, Pankaj; Jain, Divya; Puri, Goverdhan Dutt

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-minute 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 criteriafromintensive care unit. However, larger prospective studies are warranted for its evaluation and establishment of relevant cut-offs.