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

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...

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Main Authors: Angelo Zinellu, Andrea De Vito, Valentina Scano, Panagiotis Paliogiannis, Vito Fiore, Giordano Madeddu, Ivana Maida, Elisabetta Zinellu, Arduino Aleksander Mangoni, Luigi Benedetto Arru, Ciriaco Carru, Sergio Babudieri, Pietro Pirina, Alessandro Giuseppe Fois
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2021-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/13288
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author Angelo Zinellu
Andrea De Vito
Valentina Scano
Panagiotis Paliogiannis
Vito Fiore
Giordano Madeddu
Ivana Maida
Elisabetta Zinellu
Arduino Aleksander Mangoni
Luigi Benedetto Arru
Ciriaco Carru
Sergio Babudieri
Pietro Pirina
Alessandro Giuseppe Fois
author_facet Angelo Zinellu
Andrea De Vito
Valentina Scano
Panagiotis Paliogiannis
Vito Fiore
Giordano Madeddu
Ivana Maida
Elisabetta Zinellu
Arduino Aleksander Mangoni
Luigi Benedetto Arru
Ciriaco Carru
Sergio Babudieri
Pietro Pirina
Alessandro Giuseppe Fois
author_sort Angelo Zinellu
collection DOAJ
description 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.
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spelling doaj-art-8558b967aa0c4e9297fba0baa4ba77b32025-08-20T02:14:11ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-03-01150310.3855/jidc.13288The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patientsAngelo Zinellu0Andrea De Vito1Valentina Scano2Panagiotis Paliogiannis3Vito Fiore4Giordano Madeddu5Ivana Maida6Elisabetta Zinellu7Arduino Aleksander Mangoni8Luigi Benedetto Arru9Ciriaco Carru10Sergio Babudieri11Pietro Pirina12Alessandro Giuseppe Fois13Department of Biomedical Sciences, University of Sassari, Sassari, ItalyInfectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyInfectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyInfectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyInfectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyUnit of Respiratory Diseases, University Hospital Sassari (AOU), Sassari, ItalyDepartment of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, AustraliaOperative Unit of Hematology, Center for Stem Cell Transplantation, San Francesco Hospital, Nuoro, ItalyDepartment of Biomedical Sciences, University of Sassari, Sassari, ItalyInfectious and Tropical Diseases Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy 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. https://jidc.org/index.php/journal/article/view/13288COVID-19Hospital stayPaO2/FiO2 ratio
spellingShingle Angelo Zinellu
Andrea De Vito
Valentina Scano
Panagiotis Paliogiannis
Vito Fiore
Giordano Madeddu
Ivana Maida
Elisabetta Zinellu
Arduino Aleksander Mangoni
Luigi Benedetto Arru
Ciriaco Carru
Sergio Babudieri
Pietro Pirina
Alessandro Giuseppe Fois
The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
Journal of Infection in Developing Countries
COVID-19
Hospital stay
PaO2/FiO2 ratio
title The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
title_full The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
title_fullStr The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
title_full_unstemmed The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
title_short The PaO2/FiO2 ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients
title_sort pao2 fio2 ratio on admission is independently associated with prolonged hospitalization in covid 19 patients
topic COVID-19
Hospital stay
PaO2/FiO2 ratio
url https://jidc.org/index.php/journal/article/view/13288
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