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What is the natural history of oxygenation and symptoms during the course of COVID-19 amongst people staying at home? IRAS Project ID: 283310

Published: 28th May 2020

There is little research yet on people reporting symptoms from first onset of probable COVID-19 and comparing this to oximetry readings. We want to understand symptoms and oxygen levels relative to subsequent illness course for people staying at home with COVID-19. We want to know if there is any association between symptoms and subsequent deoxygenation. Do people with mild symptoms have any relative deoxygenation in their illness or not? We wonder if having an oximeter at home is helpful in detecting deoxygenation before the person is aware of it, or not? We also wonder if people like having a home oximeter or if it makes them anxious. In England, at the start of the COVID-19 pandemic in March 2020, there was a discussion about using Roth Score to detect breathlessness in remote consultations. This is a score asking people to count to 30 out-loud in one expiration and see how far they get. It was dropped as not accurate but we wonder if an individuals ability to count on expiration out-loud might be sensitive for themselves (as a change in count) and how this might relate to symptoms and oximetry, so we have also asked participants to do this.  Underpinning this study, which is observational, we wonder if oximetry is useful or not and this has implications for the public and for health spend everywhere. We hope to recruit 50 people.

We are a general practice (primary care) in England and to look at these questions we are recruiting by text once weekly for 4 weeks, our patients with mental capacity who are over 18 years old, asking them to report if they think they are in the first 7 days of COVID-19, and would like to talk about the study. If they subsequently verbally consent, then a pack containing a finger pulse oximeter, an instruction sheet, a patient information sheet, a consent form, a reply envelope and a patient diary data table sheet is dropped by arrangement on their doorstep for them to pick up.

Patients are told to use medical care as they usually would if they become ill or concerned and that they should report to medical care, an oximetry oxygen of 94% or below.

The participant fills in a diary of symptoms twice a day and, if they wish, can include any night- time symptoms. If not on day 1 then this is from memory. Also, twice a day, from day of having the pack, they are asked to count out-loud on expiration and make a note of the number they reach. They are asked to record their temperature, if they have a thermometer, or if they think they are hot. They then use the finger-pulse oximeter and record their pulse and oxygen in the table twice a day. If they are able, they can take 20 steps and record their oxygen after that. On day 14 they are asked if they liked having an oximeter and if it was useful and lastly if they were tested for Coronavirus and the result if tested. They return the result sheet, consent form and oximeter to the Health Centre after day 14.

Results will be analysed as relative change and correlations sought per person and for the cohort.

This study started on May 18th 2020. The chief investigator is Dr Jane Wilcock   jane.wilcock@nhs.net

 

 

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