• Ina Kostakis, Gary B Smith, David Prytherch, Paul Meredith, Connor Price, Anoop Chauhan, and Portsmouth Academic ConsortIum For Investigating COVID-19 (PACIFIC-19).
• Centre for Healthcare Modelling & Informatics, University of Portsmouth, Portsmouth, UK.
• Resuscitation. 2021 Jan 1; 158: 30-38.

IntroductionCoronavirus disease 2019 (COVID-19) placed increased burdens on National Health Service hospitals and necessitated significant adjustments to their structures and processes. This research investigated if and how these changes affected the patterns of vital sign recording and staff compliance with expected monitoring schedules on general wards.MethodsWe compared the pattern of vital signs and early warning score (EWS) data collected from admissions to a single hospital during the initial phase of the COVID-19 pandemic with those in three control periods from 2018, 2019 and 2020. Main outcome measures were weekly and monthly hospital admissions; daily and hourly patterns of recorded vital signs and EWS values; time to next observation and; proportions of 'on time', 'late' and 'missed' vital signs observations sets.ResultsThere were large falls in admissions at the beginning of the COVID-19 era. Admissions were older, more unwell on admission and throughout their stay, more often required supplementary oxygen, spent longer in hospital and had a higher in-hospital mortality compared to one or more of the control periods. More daily observation sets were performed during the COVID-19 era than in the control periods. However, there was no clear evidence that COVID-19 affected the pattern of vital signs collection across the 24-h period or the week.ConclusionsThe increased burdens of the COVID-19 pandemic, and the alterations in healthcare structures and processes necessary to respond to it, did not adversely affect the hospitals' ability to monitor patients under its care and to comply with expected monitoring schedules.Copyright © 2020 Elsevier B.V. All rights reserved.

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