1Department of Anaesthesiology and Critical Care, MOSC Medical College, Kerala, India
2Department of Surgery, MOSC Medical College, Kerala, India
3North Cumbria Integrated Care NHS Trust, Whitehaven, UK
Copyright © 2023 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
FUNDING
None.
AUTHOR CONTRIBUTIONS
Conceptualization: SVK, MG. Methodology: VP, NCP, MT. Data curation: SVK, NCP, NP, MT. Visualization: VP, NCP. Project administration: SP. Writing–original draft: SVK. Writing–review & editing: SVK, VP, MG.
Values are presented as mean±standard deviation or median (interquartile range) unless otherwise indicated.
COVID-19: coronavirus disease 2019; ROX: respiratory rate-oxygenation; DM: diabetes mellitus; HTN: hypertension; COPD: chronic obstructive pulmonary disease; CKD: chronic kidney disease; CAD: coronary artery disease; SOFA: Sequential Organ Failure Assessment; APACHE: Acute Physiology and Chronic Health Evaluation; HFNO: high flow nasal oxygen.
COVID-19: coronavirus disease 2019; OR: odds ratio; CI: confidence interval; ROX: respiratory rate-oxygenation; CAD: coronary artery disease; HTN: hypertension; DM: diabetes mellitus; AKI: acute kidney injury; APACHE: Acute Physiology and Chronic Health Evaluation; SOFA: Sequential Organ Failure Assessment.
Parameter | Total (n=58) | Time from ROX <4.88 to intubation |
P-value | |
---|---|---|---|---|
<12 hr (n=20) | ≥12 hr (n=38) | |||
Age (yr) | 57±14 | 55±14 | 58±14 | 0.73 |
Male (%) | 55.0 | 55.0 | 55.3 | 0.98 |
DM (%) | 48.3 | 50.0 | 47.4 | 0.84 |
HTN (%) | 50.0 | 40.0 | 55.0 | 0.27 |
COPD (%) | 3.4 | 5.0 | 2.6 | 1.00 |
CKD (%) | 6.9 | 5.0 | 8.0 | 1.00 |
CAD | 13.8 | 15.0 | 13.0 | 1.00 |
Charlson Comorbidity Index | 2 (1–3) | 2 (1–3) | 2 (1–3) | 0.26 |
Day of intubation after confirmed COVID-19 infection | 9 (3–13) | 7 (4–12) | 9 (3–13) | 0.85 |
SOFA score at admission | 3 (2–4) | 3 (2–4) | 3 (2–4) | 0.51 |
SOFA score at intubation | 4 (4–5) | 4 (4–4) | 4 (4–5) | 0.33 |
APACHE II score at admission | 15.1±3.3 | 13.8±3.3 | 16.0±2.5 | 0.85 |
ROX index at initiation of HFNO | 5.4±1.9 | 5.3±2.3 | 5.0±1.4 | 0.57 |
Parameter | Time from ROX <4.88 to intubation |
P-value | |
---|---|---|---|
<12 hr (n=20) | ≥12 hr (n=38) | ||
Extubation (%) | 88.2 | 11.8 | <0.001 |
Survival (%) | 91.7 | 8.3 | <0.001 |
Shock (%) | 20.0 | 10.5 | 0.061 |
AKI (%) | 20.0 | 80.0 | 0.051 |
ICU day | 13 (7–16) | 6 (4–11) | 0.007 |
Hospital day | 18 (14–28) | 10 (5–14) | 0.001 |
Variable | Univariable model |
Multivariable model |
||
---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | |
Age | 0.97 (0.93–1.02) | 0.30 | 0.93 (0.70–1.11) | 0.45 |
Male | 0.98 (0.32–3.01) | 0.97 | 0.32 (0.20–45.3) | 0.36 |
Day of intubation after confirmed COVID-19 infection | 0.96 (0.64–1.04) | 0.40 | 0.81 (0.64–1.04) | 0.11 |
Early intubation based on ROX index | 34.6 (6.59–182.71) | 0.00 | 690 (8.19–581) | 0.004 |
CAD | 0.33 (0.39–2.98) | 0.33 | 0.02 (0.00–4.69) | 0.16 |
HTN | 0.47 (0.15–1.51) | 0.20 | 2.32 (0.14–37.8) | 0.55 |
DM | 0.37 (0.30–2.84) | 0.00 | 0.15 (0.00–3.55) | 0.24 |
AKI | 0.48 (0.13–1.74) | 0.27 | 0.65 (0.04–9.90) | 0.75 |
Charlson Comorbidity Index | 0.77 (0.27–1.18) | 0.24 | 1.67 (0.27–10.30) | 0.57 |
APACHE II score at admission | 0.52 (0.56–1.05) | 0.34 | 0.82 (0.56–1.05) | 0.21 |
SOFA score at admission | 0.92 (0.66–1.56) | 0.69 | 4.13 (0.66–25.80) | 0.13 |
SOFA score at intubation | 0.29 (0.40–2.85) | 0.49 | 0.29 (0.30–2.85) | 0.29 |
Values are presented as mean±standard deviation or median (interquartile range) unless otherwise indicated. COVID-19: coronavirus disease 2019; ROX: respiratory rate-oxygenation; DM: diabetes mellitus; HTN: hypertension; COPD: chronic obstructive pulmonary disease; CKD: chronic kidney disease; CAD: coronary artery disease; SOFA: Sequential Organ Failure Assessment; APACHE: Acute Physiology and Chronic Health Evaluation; HFNO: high flow nasal oxygen.
Values are presented as median (interquartile range) unless otherwise indicated. ROX: respiratory rate-oxygenation; AKI: acute kidney injury; ICU: intensive care unit.
COVID-19: coronavirus disease 2019; OR: odds ratio; CI: confidence interval; ROX: respiratory rate-oxygenation; CAD: coronary artery disease; HTN: hypertension; DM: diabetes mellitus; AKI: acute kidney injury; APACHE: Acute Physiology and Chronic Health Evaluation; SOFA: Sequential Organ Failure Assessment.