S19 Relevance of prediction scores derived from the SARS-CoV-2 first wave, in the UK COVID-19 second wave, for early discharge, severity and mortality: a PREDICT COVID UK prospective observational cohort study

Abstract

S19 Figure 1 SOARS and 4C mortality score in PREDICT and ISARIC cohorts Spoken sessions A16 Thorax 2021;76(Suppl 2):A1–A205 on N ovem er 2, 2021 by gest. P rocted by coright. httphorax.bm jcom / T hrax: frst pulished as 10.113orax-2021-B T S absacts.25 on 8 N ovem er 221. D ow nladed fom in the PREDICT cohort and 9.5% in the ISARIC cohort were admitted despite SOARS score of 0–1. Conclusion SOARS and 4C Mortality Score remains valid and relevant to their purpose, transforming complex clinical presentations into tangible numbers, aiding objective decision making, despite evolving viral subtype and treatment advances altering patient demographic and mortality. More importantly both scores are easily implemented within urgent care pathways for safe admission avoidance especially to a VH model. The new normal? Novel and remote strategies for pulmonary rehabilitation S20 COMBINING PHYSICAL ACTIVITY BEHAVIOURAL MODIFICATION STRATEGIES ALONGSIDE COGNITIVE BEHAVIOURAL THERAPY DURING PULMONARY REHABILITATION IN PATIENTS WITH COPD: AN INTERIM ANALYSIS OF A PILOT RCT M Armstrong, E Hume, L McNeillie, F Chambers, L Wakenshaw, G Burns, K HeslopMarshall, I Vogiatzis. Northumbria University, Newcastle upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK 10.1136/thorax-2021-BTSabstracts.26 Introduction In patients with COPD, pulmonary rehabilitation (PR) improves exercise capacity, but continues to report inconsistent improvements in physical activity, particularly in those with low baseline physical activity levels. In addition, patients with elevated levels of anxiety and/or depression are typically less able to manage symptoms and improve physical activity. Objective To determine the efficacy of combining physical activity behavioural modification strategies (PA) with cognitive behavioural therapy (CBT) during PR in improving patients’ experiences of physical activity and steps/day in COPD patients with low baseline physical activity levels and high anxiety and/or depression. Methods In this pilot RCT, 23 patients (mean±SD: FEV1: 40 ±17%, baseline steps/day: 2913±1821, HADS Anxiety: 11±3, HADS Depression: 11±4) were assigned 1:1 to receive PR +CBT, or PA (comprising motivational interviews, step count monitoring, feedback using a pedometer and goal setting) alongside PR+CBT (PA+PR+CBT). Assessments included patients’ experiences of the amount and difficulty of physical activity captured by the Clinical PROactive Physical Activity in COPD (C-PPAC) instrument, accelerometer steps/day, the 6MWT, CAT and HADS questionnaires. Results We found significant and clinically important improvements in favour of PA+PR+CBT compared to PR+CBT intervention in the C-PPAC total score and steps/day. Meanwhile, similar significant and clinically important improvements in the 6MWT, CAT and HADS depression scores were reported across both groups (table 1). Conclusions Providing anxious and/or depressed patients with physical activity behavioural modification strategies alongside CBT during PR is more favourable for improving patients’ experiences of the amount and difficulty of physical activity and steps/day than providing CBT and PR. S21 FEASIBILITY OF SMARTPHONE-BASED PHYSICAL ACTIVITY TELE-COACHING IN LUNG TRANSPLANT RECIPIENTS E Hume, H Muse, K Wallace, M Wilkinson, K Heslop-Marshall, A Nair, J Sanchez, J Benavent, J Roldan, S Clark, I Vogiatzis. Northumbria University, Newcastle upon Tyne, UK; Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK; Chest Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Linkcare Health Services SL, Barcelona,