Prediction and Correlation of Midnoon Dip in Oxygen Saturation and Circadian Clock Discordance with Coronavirus Disease 2019 Mortality

Background: Various factors have been identified as contributors to mortality in coronavirus disease 2019 (COVID-19). This study aims to elucidate the relationship between admission investigations, hourly oxygen saturation (SpO2), and circadian rhythm in COVID-19 mortality. Materials and Methods: A...

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Main Authors: Madhav Prabhu, R. Balasubramanian, Harpreet Kour, Arathi Darshan, Jayaprakash Appajigol, Rekhs S. Patil, JangBahadur Prasad
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:APIK Journal of Internal Medicine
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Online Access:https://journals.lww.com/10.4103/ajim.ajim_116_23
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Summary:Background: Various factors have been identified as contributors to mortality in coronavirus disease 2019 (COVID-19). This study aims to elucidate the relationship between admission investigations, hourly oxygen saturation (SpO2), and circadian rhythm in COVID-19 mortality. Materials and Methods: A retrospective cross-sectional study was conducted using sociodemographic and laboratory data from the medical records department of a tertiary care hospital. Data from 218 COVID-19 fatalities during the second wave (March 2021–June 2021) were analyzed using means, percentages, averages, correlation, and coefficients of determination with SPSS software version 20.0. Results: The majority of deaths occurred in males, the unemployed, those over 60 years, and patients with comorbidities. The study also examined contributing factors in 35.3% of patients who died without comorbidities. Elevated levels of lactate dehydrogenase, interleukin-6, high-sensitivity C-reactive protein, D-dimer, and ferritin were predictive of hypoxemia progression. A notable dip in mean SpO2 at midday indicated circadian rhythm disruption in COVID-19 patients. Conclusions: A midday dip in SpO2, likely due to circadian rhythm disruption, was a notable feature in patients who died due to COVID-19. Elevated inflammatory markers are significant predictors of hypoxemia progression.
ISSN:2666-1802
2666-1810