The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients

  • Angelo Zinellu Department of Biomedical Sciences, University of Sassari, Sassari, Italy
  • Andrea De Vito Infectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Valentina Scano Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Panagiotis Paliogiannis Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Vito Fiore Infectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Giordano Madeddu Infectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Ivana Maida Infectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Elisabetta Zinellu Unit of Respiratory Diseases, University Hospital Sassari (AOU), Sassari, Italy
  • Arduino Aleksander Mangoni Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Luigi Benedetto Arru Operative Unit of Hematology, Center for Stem Cell Transplantation, San Francesco Hospital, Nuoro, Italy
  • Ciriaco Carru Department of Biomedical Sciences, University of Sassari, Sassari, Italy
  • Sergio Babudieri Infectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Pietro Pirina Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
  • Alessandro Giuseppe Fois Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
Keywords: COVID-19, Hospital stay, PaO2/FiO2 ratio

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.

Published
2021-03-31
How to Cite
1.
Zinellu A, De Vito A, Scano V, Paliogiannis P, Fiore V, Madeddu G, Maida I, Zinellu E, Mangoni AA, Arru LB, Carru C, Babudieri S, Pirina P, Fois AG (2021) The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients. J Infect Dev Ctries 15:353-359. doi: 10.3855/jidc.13288
Section
Coronavirus Pandemic

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