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J Infect Dev Ctries . The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients

tetano

Editor, Senior Moderator
J Infect Dev Ctries


. 2021 Mar 31;15(3):353-359.
doi: 10.3855/jidc.13288.
The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients


Angelo Zinellu[SUP] 1 [/SUP], Andrea De Vito[SUP] 2 [/SUP], Valentina Scano[SUP] 3 [/SUP], Panagiotis Paliogiannis[SUP] 3 [/SUP], Vito Fiore[SUP] 2 [/SUP], Giordano Madeddu[SUP] 2 [/SUP], Ivana Maida[SUP] 2 [/SUP], Elisabetta Zinellu[SUP] 4 [/SUP], Arduino Aleksander Mangoni[SUP] 5 [/SUP], Luigi Benedetto Arru[SUP] 6 [/SUP], Ciriaco Carru[SUP] 1 [/SUP], Sergio Babudieri[SUP] 2 [/SUP], Pietro Pirina[SUP] 3 [/SUP], Alessandro Giuseppe Fois[SUP] 7 [/SUP]



Affiliations

Abstract

Introduction: The early identification of factors that predict the length of hospital stay (HS) in patients affected by coronavirus desease (COVID-19) might assist therapeutic decisions and patient flow management.
Methodology: We collected, at the time of admission, routine clinical, laboratory, and imaging parameters of hypoxia, lung damage, inflammation, and organ dysfunction in a consecutive series of 50 COVID-19 patients admitted to the Respiratory Disease and Infectious Disease Units of the University Hospital of Sassari (North-Sardinia, Italy) and alive on discharge.
Results: Prolonged HS (PHS, >21 days) patients had significantly lower PaO2/FiO2 ratio and lymphocytes, and significantly higher Chest CT severity score, C-reactive protein (CRP) and lactic dehydrogenase (LDH) when compared to non-PHS patients. In univariate logistic regression, Chest CT severity score (OR = 1.1891, p = 0.007), intensity of care (OR = 2.1350, p = 0.022), PaO2/FiO2 ratio (OR = 0.9802, p = 0.007), CRP (OR = 1.0952, p = 0.042) and platelet to lymphocyte ratio (OR = 1.0039, p = 0.036) were significantly associated with PHS. However, in multivariate logistic regression, only the PaO2/FiO2 ratio remained significantly correlated with PHS (OR = 0.9164; 95% CI 0.8479-0.9904, p = 0.0275). In ROC curve analysis, using a threshold of 248, the PaO2/FiO2 ratio predicted PHS with sensitivity and specificity of 60% and 91%, respectively (AUC = 0.780, 95% CI 0.637-0.886 p = 0.002).
Conclusions: The PaO2/FiO2 ratio on admission is independently associated with PHS in COVID-19 patients. Larger prospective studies are needed to confirm this finding.

Keywords: COVID-19; FiO2; PaO2; hospital stay; ratio.
 
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