Outcomes of Hospitalised COVID-19 Patients Arriving With Hypoxic Respiratory Failure - 13/07/24

Doi : 10.1016/j.hlc.2023.10.023

William Giesing, MD ^a,^⁎ , Hywel Soney, DO ^a, Lucas Wang, MD ^a, Lawrence Hoang, MD ^a, Mingyang Cui, MSc ^b, Sri Prathivada, MD ^c, Manavjot Sidhu, MD ^c,^d
^a Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, TX, USA
^b Clinical Research Institute, Methodist Dallas Medical Center, Dallas, TX, USA
^c Methodist Dallas Cardiovascular Consultants, Methodist Medical Group, Dallas, TX, USA
^d Division of Cardiology, Methodist Dallas Medical Center, Dallas, TX, USA

^∗Corresponding author at: 1441 N Beckley Ave, Dallas, TX, 75203 USA1441 N Beckley AveDallasTX75203USA

connectez-vous ou créez un compte

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 13 July 2024

Abstract

Background

Hypoxia is a common complication seen in people with COVID-19 and can often be the presenting symptom.

Methods

Using a multi-centre observational database, we analysed 3,624 hospitalised COVID-19 PCR-positive patients at Methodist Health System, Dallas, Texas, USA from March 2020 to December 2020. We compared in-hospital death or hospice referral rates and major adverse cardiovascular events (MACE) between patients with four levels of oxygen (O₂) requirements (0–1 L/min, 2–10 L/min, 11–20 L/min, 21–100 L/min). MACE included congestive heart failure (CHF) exacerbations, myocardial infarctions (MI), strokes, pulmonary embolism (PE) / deep venous thrombosis (DVT), and shock. Logistic regression analysis was used to determine comorbidities and demographics associated with mortality. Multinomial regression analysis was used to find which of these variables were associated with hypoxia.

Results

Patients who arrived needing 0–1 L/min of O₂ had reduced risk of mortality compared to those requiring 2–10 L/min (OR=1.54, 95% CI=1.207–1.976, p<0.0001), 11–20 L/min (OR=4.55, 95% CI=3.169–6.547, p<0.0001), or 21–100 L/min (OR=12.06, 95% CI=8.548–17.016, p<0.0001). In addition, patients who arrived needing 0–1 L/min of O₂ showed reduced risk of MACE compared to those requiring 2–10 L/min (OR=1.20, 95% CI=1.029–1.409, p<0.0001), 11–20 L/min (OR=2.76, 95% CI 2.06–3.696, p<0.0001), or 21–100 L/min (OR=6.74, 95% CI 4.966–9.155, p<0.0001).

Conclusion

Hypoxia on arrival is associated with a significantly increased risk of mortality and MACE among hospitalised patients with COVID-19. This data will promote better prognostication and help reduce negative outcomes in an inpatient setting.

Le texte complet de cet article est disponible en PDF.

Keywords : COVID-19, Hypoxia, Major adverse cardiovascular events, Mortality