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Association Between Hypoxemia and Mortality in Patients With COVID-19
J. Xie, N. Covassin, Z. Fan, P. Singh, W. Gao, G. Li, T. Kara, VK. Somers,
Language English Country Great Britain
Document type Journal Article
NLK
ProQuest Central
from 1997-01-01 to 2020-12-31
Nursing & Allied Health Database (ProQuest)
from 1997-01-01 to 2020-12-31
Health & Medicine (ProQuest)
from 1997-01-01 to 2020-12-31
Family Health Database (ProQuest)
from 1997-01-01 to 2020-12-31
Public Health Database (ProQuest)
from 1997-01-01 to 2020-12-31
- MeSH
- Betacoronavirus isolation & purification MeSH
- Risk Assessment methods MeSH
- Hypoxia * diagnosis etiology therapy MeSH
- Coronavirus Infections * complications diagnosis mortality physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality MeSH
- Oxygen Inhalation Therapy * methods statistics & numerical data MeSH
- Pandemics * MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Oxygen Consumption MeSH
- Severity of Illness Index MeSH
- Pneumonia, Viral * blood complications diagnosis etiology mortality physiopathology therapy MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- China MeSH
OBJECTIVE: To identify markers associated with in-hospital death in patients with coronavirus disease 2019 (COVID-19)-associated pneumonia. PATIENTS AND METHODS: A retrospective cohort study was conducted of 140 patients with moderate to critical COVID-19-associated pneumonia requiring oxygen supplementation admitted to the hospital from January 28, 2020, through February 28, 2020, and followed up through March 13, 2020, in Union Hospital, Wuhan, China. Oxygen saturation (SpO2) and other measures were tested as predictors of in-hospital mortality in survival analysis. RESULTS: Of 140 patients with COVID-19-associated pneumonia, 72 (51.4%) were men, with a median age of 60 years. Patients with SpO2 values of 90% or less were older and were more likely to be men, to have hypertension, and to present with dyspnea than those with SpO2 values greater than 90%. Overall, 36 patients (25.7%) died during hospitalization after median 14-day follow-up. Higher SpO2 levels after oxygen supplementation were associated with reduced mortality independently of age and sex (hazard ratio per 1-U SpO2, 0.93; 95% CI, 0.91 to 0.95; P<.001). The SpO2 cutoff value of 90.5% yielded 84.6% sensitivity and 97.2% specificity for prediction of survival. Dyspnea was also independently associated with death in multivariable analysis (hazard ratio, 2.60; 95% CI, 1.24 to 5.43; P=.01). CONCLUSION: In this cohort of patients with COVID-19, hypoxemia was independently associated with in-hospital mortality. These results may help guide the clinical management of patients with severe COVID-19, particularly in settings requiring strategic allocation of limited critical care resources. TRIAL REGISTRATION: Chictr.org.cn Identifier: ChiCTR2000030852.
Department of Cardiovascular Medicine Mayo Clinic Rochester MN
Guang An Men Hospital China Academy of Medical Sciences Beijing China
References provided by Crossref.org
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- $a OBJECTIVE: To identify markers associated with in-hospital death in patients with coronavirus disease 2019 (COVID-19)-associated pneumonia. PATIENTS AND METHODS: A retrospective cohort study was conducted of 140 patients with moderate to critical COVID-19-associated pneumonia requiring oxygen supplementation admitted to the hospital from January 28, 2020, through February 28, 2020, and followed up through March 13, 2020, in Union Hospital, Wuhan, China. Oxygen saturation (SpO2) and other measures were tested as predictors of in-hospital mortality in survival analysis. RESULTS: Of 140 patients with COVID-19-associated pneumonia, 72 (51.4%) were men, with a median age of 60 years. Patients with SpO2 values of 90% or less were older and were more likely to be men, to have hypertension, and to present with dyspnea than those with SpO2 values greater than 90%. Overall, 36 patients (25.7%) died during hospitalization after median 14-day follow-up. Higher SpO2 levels after oxygen supplementation were associated with reduced mortality independently of age and sex (hazard ratio per 1-U SpO2, 0.93; 95% CI, 0.91 to 0.95; P<.001). The SpO2 cutoff value of 90.5% yielded 84.6% sensitivity and 97.2% specificity for prediction of survival. Dyspnea was also independently associated with death in multivariable analysis (hazard ratio, 2.60; 95% CI, 1.24 to 5.43; P=.01). CONCLUSION: In this cohort of patients with COVID-19, hypoxemia was independently associated with in-hospital mortality. These results may help guide the clinical management of patients with severe COVID-19, particularly in settings requiring strategic allocation of limited critical care resources. TRIAL REGISTRATION: Chictr.org.cn Identifier: ChiCTR2000030852.
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