SARS-CoV Infection
Conditions
Brief summary
As part of the Coronavirus Infectious Disease 2019 (COVID19) pandemic, the hospital care system is facing a major strain. Patients with SARS-Cov2 (severe acute respiratory syndrome coronavirus 2 ) infection can worsen very quickly, possibly presenting, within hours, severe respiratory failure requiring urgent specialized care. Therefore, it is essential to develop emergency assessment tools to assess relevant criteria to decide which patients must be kept under hospital monitoring and which patients can be treated on outpatient care. The aim of this study is to assess the efficacy of STST in the decision to hospitalize patients consulting emergency department for a SARS-Cov2 infection. The investigators wish to show that the addition of this test to the usual hospitalization criteria reduces the proportion of patients hospitalized 48 hours after their first visit to the emergency department.
Interventions
DIAGNOSTIC_TESTSit to stand test
The sit to stand test (or STST) is a test consisting of performing as many sit-to-stand tests as possible in one minute, from a chair without armrests. We note before and during this test, the SpO2 (pulsed oxygen saturation) (rest value and minimum value during exercise), heart rate (HR), dyspnea on the modified Borg scale as well as the number of chair lifts performed. completely and minimum SpO2 during the recovery phase. The possible results from this one-minute test are as follows: * If SpO2 \<90% or appearance of signs of respiratory distress: Immediate stop of the test and hospitalization * SpO2 \<90% or decrease in SpO2 ≥ 4% during the test or during the recovery period: Hospitalization * SpO2 ≥90% and no decrease in SpO2 ≥ 4% during the test or during the recovery period which will be 3 minutes maximum: discharge.
Sponsors
University Hospital, Rouen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult (≥18 years old) * Admit to emergency department for suspected SARS-Cov2 infection * SARS-CoV2 infection confirmed by Real Time Polymerase Chain Reaction (RT - PCR) before the first discharge of emergency department * Patient affiliated or beneficiary of a health care insurance * Effective contraception in women of childbearing age. For postmenopausal women, amenorrhea for at least 12 months before the inclusion visit
Exclusion criteria
* Patient presenting criteria for admission to intensive care: signs of acute respiratory distress , respiratory rate\> 30 / min, oxygen dependence \> 6L / min on face mask for an SpO2 ≥ 95% or an arterial oxygen pressure \>8kPa, neurological disorders, systolic blood pressure (SBP) \<90mmHg despite fluid resuscitation, lactates\> 2mmol / L, bradycardia, or heart rate disorders * Patient with SpO2 \<90% in spontaneous ventilation in room air at rest * Patient with functional impairment or deterioration of the general condition leading to the inability to perform STST * Patient with a resting SBP\> 180 mmHg or resting diastolic blood pressure (DBP)\> 100 mmHg or resting heart rate (HR)\> 120 / min * Patient with decompensated or unbalanced cardiac pathology * Patient previously included in the study following a previous admission to emergency department * Patient deprived of liberty, unable to consent freely * Patient non affiliated or beneficiary of a health care insurance
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of late hospitalizations, within 48 hours of first discharge from emergency department, and motivated by worsening symptoms secondary to SARS-Cov2 infection. | 7 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of immediate hospitalizations after the 1st admission at emergency department. | 7 days | — |
| Proportion of adverse events related to SARS-Cov2 infection within 7 days of patient inclusion. | 7 days | The adverse events identified are: * medical consultation, * readmission to the emergency department, * hospitalization, * hospitalization in intensive care unit, * death. |
| Establish the correlation between the number of chair rises performed on STST and the occurrence of an adverse event. | 7 days | The adverse events identified are: * medical consultation, * readmission to the emergency department, * hospitalization, * hospitalization in intensive care unit, * death. |
| Correlation between SpO2 and the occurrence of an adverse event | 7 days | the difference between the measurement of SpO2 before and after STST will be used to establish the correlation between this difference and the occurrence of an adverse event. |
| Correlation between heart rate (HR) and the occurrence of an adverse event | 7 days | the difference between the measurement of HR before and after STST will be used to establish the correlation between this difference and the occurrence of an adverse event. |
| Correlation between dyspnea score and the occurrence of an adverse event | 7 days | the difference between the measurement of dyspnea score before and after STST will be used to establish the correlation between this difference and the occurrence of an adverse event. |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORElise ARTAUD-MACARI, MD
Pneumology, Thoracic Oncology and Respiratory Intensive Care Unit
STUDY_DIRECTORFairuz BOUJIBAR, PhD
Thoracic Surgery
Outcome results
None listed