Jane Wilcock - SciTok

59:34

What is the value of community oximetry monitoring in people with SARS-CoV-2? – A prospective, open-label clinical study

Jane Wilcock ,

Ciaran Grafton-Clarke

Webinar on COVID-19 Remote assessment of sore throat and respiratory symptoms

Paper

Preprint Page

jane.wilcock@nhs.netBackground In people with COVID-19, hypoxia at the time of admission is known to be related to mortality. Monitoring of oxygen saturations (SpO2) is therefore an increasingly common part of community-based care, with the aim of improving the identification of adults who are deteriorating. We set out to investigate whether rigid SpO2 triggers, or absolute change in SpO2, is more indicative of deterioration in COVID-19.Methods A prospective, uncontrolled, open-label study in a large UK general practice was conducted between May and November 2020. Participants recorded twice daily oximetry and symptom diary for 14 days after test-confirmed COVID-19. Primary outcomes were the proportion of people whose SpO2 dropped to ≤ 94% and ≤ 92%, the average maximum reduction in SpO2, and admission to hospital. We also investigated the relationship between MRC Dyspnoea scale, modified Roth score, and SpO2 through correlation analyses.Results 52 participants were recruited, following which 41 participants completed the study. The average age was 45.9 years with 63.4% identifying as female. The mean maximum reduction in SpO2 was 2.8%. The average time to maximum reduction in SpO2 was 6.4 days. Nine participants (22.0%) had a reduction in SpO2 to ≤94%. Three of these had a reduction in SpO2 to ≤92%, for which all three were admitted to hospital. Modified Roth score and SpO2 were weakly positively correlated (.31). MRC dyspnoea scale score and SpO2 were moderately negatively correlated (-.53).Conclusions A reduction in SpO2 to ≤92% was found to be highly predictive for admission to hospital. Modified Roth score or MRC dyspnoea scale scores should not be used as proxy measures for oximetry. This study contributes to the ongoing narrative around community-based oximetry and provides insight and recommendations for those currently engaging in or planning to roll out similar schemes.Strengths and limitations of this study<ul class="ul1" style="font-size: medium;"><li class="li1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue";">This study is pragmatically designed to answer an important clinical question in primary care. </li><li class="li1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue";">This study focused on previously published values of SpO2 for triggering escalation of care and therefore provides answers based on current clinical practice. </li><li class="li1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue";">11 of the 52 patients who were recruited into the study did not return their oximeter or oximetry diary at the end of the study period. </li><li class="li1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue";">We did not validate the accuracy or reliability of the oximetry / symptom diaries, as these were self-completed by the participants themselves. </li><li class="li1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue";">Other than admission to hospital and mortality within the study period, no other clinical outcomes have been recorded. </li></ul>Funding statement This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.<p class="p2" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> Competing interests Jane Wilcock has no competing interests to declare.Ciaran Grafton-Clarke has no competing interests to declare.Tessa Coulson has no competing interests to declare.<p class="p2" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> Competing Interest Statement The authors have declared no competing interest.<p class="p2" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> Clinical TrialIndependent UK GP research not registered. HRA IRAS project ID: 283310 Ethics review: 20/HRA/2326<p class="p2" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> Clinical Protocols <p class="p4" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; color: rgb(220, 161, 13);"><a href="https://www.researchgate.net/publication/348170563_What_is_the_value_of_community_oximetry_monitoring_in_people_with_SARS-CoV-2_-_A_prospective_open-label_clinical_study">https://www.researchgate.net/publication/348170563_What_is_the_value_of_community_oximetry_monitoring_in_people_with_SARS-CoV-2_-_A_prospective_open-label_clinical_study</a><p class="p2" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> Funding Statement Funded by chief investigator <p class="p5" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 23px;"> Author Declarations  I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:HRA ethics committee approval 20/HRA/2326All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.Yes<p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> <p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> <p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> <p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> <p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;"> <p class="p6" style="margin: 0px 0px 2px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 18px; line-height: normal; font-family: "Helvetica Neue"; min-height: 22px;">

28:35

Vitamin D Update

Jane Wilcock

Vitamin D Update - Live Webinar at ABMA

1. Revision of vitamin D recommendations for primary care general practitioners. 2. The significance of association between vitamin D deficiency and Covid-19.

1:04:30

COVID 19 - Framework for Remote Consultation

Jane Wilcock

ABMA Webinar

Related paper: Remote care for people with dementia during covid

Webinar on COVID 19 - Framework for Remote Consultation

1:00:12

Study title: Public Evaluation of Face Shield (Visor) Use whilst Shopping during the Coronavirus Pandemic 2: one patient test group and two friend test groups in England

Jane Wilcock

ABMA Webinar on Public Evaluation of Face Shield (Visor) Use whilst Shopping during the Coronavirus Pandemic

Preprint

Background During the COVID-19 pandemic there has been heated discussion about whether the public should wear face coverings to protect others or themselves. Face coverings are masks of various grades and face shields (called visors in UK). Face shield (visor) use has not been promoted for the public in England. On 5 th June 2020, the government has told the public that they must wear a face covering at all times on public transport or when attending hospitals as a visitor or outpatient. There is also a recommendation to wear a face covering in other enclosed public spaces where social distancing is not possible and meeting strangers. Literature has been dominated by mask discussion and we wanted to ascertain public view on face shield use as an alternative.

03:46

What is the value of community oximetry monitoring in people with SARS-CoV-2? A prospective, open-label clinical study

Jane Wilcock ,

Ciaran Grafton-Clarke ,

Tessa Coulson

Video Abstract (AI generated)

Paper

Preprint

BackgroundIn people with COVID-19, hypoxia at the time of admission is known to be related to mortality. Monitoring of oxygen saturations (SpO2) is therefore an increasingly common part of community-based care, with the aim of improving the identification of adults who are deteriorating. We set out to investigate whether rigid SpO2 triggers, or absolute change in SpO2, is more indicative of deterioration in COVID-19. MethodsA prospective, uncontrolled, open-label study in a large UK general practice was conducted between May and November 2020. Participants recorded twice daily oximetry and symptom diary for 14 days after test-confirmed COVID-19. Primary outcomes were the proportion of people whose SpO2 dropped to [≤] 94% and [≤] 92%, the average maximum reduction in SpO2, and admission to hospital. We also investigated the relationship between MRC Dyspnoea scale, modified Roth score, and SpO2 through correlation analyses. Results52 participants were recruited, following which 41 participants completed the study. The average age was 45.9 years with 63.4% identifying as female. The mean maximum reduction in SpO2 was 2.8%. The average time to maximum reduction in SpO2 was 6.4 days. Nine participants (22.0%) had a reduction in SpO2 to [≤]94%. Three of these had a reduction in SpO2 to [≤]92%, for which all three were admitted to hospital. Modified Roth score and SpO2 were weakly positively correlated (.31). MRC dyspnoea scale score and SpO2 were moderately negatively correlated (-.53). ConclusionsA reduction in SpO2 to [≤]92% was found to be highly predictive for admission to hospital. Modified Roth score or MRC dyspnoea scale scores should not be used as proxy measures for oximetry. This study contributes to the ongoing narrative around community-based oximetry and provides insight and recommendations for those currently engaging in or planning to roll out similar schemes. Strengths and limitations of this studyO_LIThis study is pragmatically designed to answer an important clinical question in primary care. C_LIO_LIThis study focused on previously published values of SpO2 for triggering escalation of care and therefore provides answers based on current clinical practice. C_LIO_LI11 of the 52 patients who were recruited into the study did not return their oximeter or oximetry diary at the end of the study period. C_LIO_LIWe did not validate the accuracy or reliability of the oximetry / symptom diaries, as these were self-completed by the participants themselves. C_LIO_LIOther than admission to hospital and mortality within the study period, no other clinical outcomes have been recorded. C_LI Funding statementThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Competing interestsJane Wilcock has no competing interests to declare. Ciaran Grafton-Clarke has no competing interests to declare. Tessa Coulson has no competing interests to declare.

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What is the value of community oximetry monitoring in people with SARS-CoV-2? – A prospective, open-label clinical study

Vitamin D Update

COVID 19 - Framework for Remote Consultation

Study title: Public Evaluation of Face Shield (Visor) Use whilst Shopping during the Coronavirus Pandemic 2: one patient test group and two friend test groups in England

What is the value of community oximetry monitoring in people with SARS-CoV-2? A prospective, open-label clinical study