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Background Patients discharged from hospital following treatment for COVID-19 infection, experience ongoing breathlessness during recovery 1 One minute sit-to-stand test (1MSTS) has been recommended to identify desaturation in these patients during acute and post-acute phase 2 We aimed to assess the feasibility of 1MSTS to monitor recovery in COVID-19 patients following hospital discharge Methods All patients admitted to our hospital, with COVID-19 were offered clinic review approximately 6-8 weeks post discharge This clinical assessment included 1MSTS, bloods and imaging If ongoing clinical concern, a second review was offered at 3 months We reviewed the 1MSTS in terms of (a) ability to complete test (b) oxygen desaturation >3%2 (c) longitudinal improvement in 1MSTS repetitions Fisher's exact and Mann-Whitney tests were used to compare variables Results 366/413(88%) COVID-19 patients reviewed at initial follow-up clinic completed a 1MSTS and 141 repeated 1MSTS at 3 months Those who were unable to complete a 1MSTS at initial clinic were older, frailer and had longer hospital admissions with COVID-19 (table 1) 77/366 (21%) patients had desaturation of >3% on 1MSTS at initial follow-up, which was associated with severe disease during admission (p=0 051) and persisting radiographic abnormalities (p=0 0018) No association between desaturation and symptom burden was noted Clinicians found 1MSTS with no desaturation to be helpful in the discharge process if other investigations were normal Desaturation during initial clinic was not predictive of abnormal cardiac and respiratory investigations at 3 month followup (p=0 317) An improvement in number of repetitions/minute between clinic visits did not correlate with an improvement in VAS breathlessness (p=0 099), MRC score (p=0 267) or imaging (p=0 448) Conclusion The majority of patients recovering from COVID-19 can perform 1MSTS at follow-up clinic Those unable were generally more frail, older and with co-morbidities 1MSTS helped with discharge decisions at 6-8 weeks However, the wider utility of the 1MSTS results is limited in COVID-19 follow-up Serial measurements were not helpful in predicting symptomatic or radiological improvement

Introduction Management of malignant pleural disease has advanced over the past decade with the role of a pleural specialist service becoming increasingly essential in efforts to optimise patient care. The use of indwelling pleural catheters (IPC) has changed the arena in which malignant pleural effusions (MPE) can be managed, allowing more patient autonomy and less use of hospital resources. The LENT scoring system, validated in 2014, is often used to guide decision making in patients with MPE. Current ATS recommendations suggest IPCs are not suitable in individuals with a ‘very short survival’ prognosis however this determination is variable and is an example of where the LENT scoring system may be involved. Methods Retrospective analysis was carried out on patients who underwent IPC insertion at our institution between 2016 and 2019. All patients were seen in the specialist pleural service and underwent subsequent intervention. Data collected included primary cancer diagnosis, date of first pleural aspiration, LENT score, observed complications, IPC removal date if applicable and date of death to calculate survival time. Results 58 patients underwent successful IPC insertion of which 5 were for non-malignant disease (2/5 refractory heart failure, 3/5 advanced liver cirrhosis). The remaining 53 patients all had a confirmed pathological diagnosis of malignant pleural effusion. At the time of submission, 8 patients remained alive and were excluded from analysis leaving a remaining 45 cases. Using LENT assessment 13/45 classed as high risk, 31/45 as moderate and 1/45 as low. The observed average survival time in high risk patients was 122 days and median 93 days. This was notably higher than the anticipated 44 days predicted median survival time noted in the literature. Conclusion Our data suggests that high risk patients according to LENT assessment were more likely to live longer following IPC intervention and aftercare. This suggests that use of prognostic assessment tools may be ineffective in this sub-group and should be employed with caution. The improved patient outcomes reinforce the benefit of a dynamic responsive pleural service. They may also reflect upon the increased recognition of tumour heterogeneity alongside the recent advent of novel molecular based therapies.