Is it safe to start steroids at home for a COPD exacerbation after virtual assessment in the COVID-19 era?

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TABLE 1

Virtual assessment of acute COPD exacerbation

Assessment ^a	Interpretation
Count the respiratory rate	A rate > 30 breaths/minute indicates increased work of breathing
If possible, note increased activity of accessory muscles	Increased accessory muscle activity indicates ongoing respiratory distress
Assess mentation and look for flapping tremors (asterixis)	Changes in mentation and presence of asterixis suggest ongoing acute respiratory failure

↵a There is no clear guidance on the assessment of acute exacerbation of chronic obstructive pulmonary disease (COPD) through a virtual visit. This table is to help clinical assessment through virtual visits and is drawn from the Global Initiative for Chronic Obstructive Lung Disease recommendations for assessment of exacerbation of COPD for hospitalized patients.
Based on information in reference 7.