tetano
Editor, Senior Moderator
Intern Emerg Med
. 2023 Jan 18.
doi: 10.1007/s11739-023-03196-w. Online ahead of print.
Association between PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio and thrombotic events in COVID-19 patients
Lorenzo Loffredo[SUP] 1 [/SUP], Pasquale Pignatelli[SUP] 2 [/SUP], Matteo Pirro[SUP] 3 [/SUP], Giancarlo Ceccarelli[SUP] 4 [/SUP], Alessandra Oliva[SUP] 4 [/SUP], Enrico Maggio[SUP] 2 [/SUP], Francesca Cancelli[SUP] 4 [/SUP], Damiano D'Ardes[SUP] 5 6 [/SUP], Maria Amitrano[SUP] 7 [/SUP], Anna Maria Zicari[SUP] 8 [/SUP], Bianca Laura Cinicola[SUP] 8 [/SUP], Gloria Taliani[SUP] 9 [/SUP], Roberto Cangemi[SUP] 9 [/SUP], Miriam Lichtner[SUP] 4 [/SUP], Marco Falcone[SUP] 10 [/SUP], Federica Orlando[SUP] 2 [/SUP], Francesco Pugliese[SUP] 4 [/SUP], Mario Venditti[SUP] 4 [/SUP], Claudio Maria Mastroianni[SUP] 4 [/SUP], Francesco Violi[SUP] 6 [/SUP]; COVID-Group
Collaborators, Affiliations
Abstract
PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (P/F ratio) is considered a marker of hypoxia/hypoxemia and mortality. Several prothrombotic changes are associated with the decrease of P/F ratio. The role of P/F ratio in patients with arterial and venous thrombosis remains unclear. The aim of this study was to assess in patients with coronavirus disease 2019 (COVID-19), the association between P/F ratio and arterial/venous thrombosis. One thousand and four hundred and six COVID-19 patients were recruited; 289 (21%) patients had P/F ratio < 200 and 1117 (79%) ≥ 200. Compared to the patients with P/F ratio ≥ 200, those with P/F ratio < 200 were older and with higher levels of glycemia, D-dimer and lower levels of albumin. Multiple linear regression analysis showed that albumin (standardized coefficient β: 0.156; SE: 0.001; p = 0.0001) and D-dimer (standardized coefficient β: -0.135; SE: 0.0001; p = 0.0001) were associated with P/F ratio. During the hospitalization 159 patients were transferred in intensive care unit (ICU), 253 patients died, 156 patients had arterial or venous thrombotic events. A bivariate logistic analysis was performed to analyze the predictors of thrombosis in COVID-19 patients; P/F ratio < 200 (Odds Ratio: [OR] 1.718, 95% Confidence Interval [CI] 1.085-2.718, p = 0.021), albumin (OR 1.693, 95% CI 1.055-2.716, p = 0.029), D-dimer (OR 3.469, 95% CI 2.110-5.703, p < 0.0001), coronary artery disease (CAD) (OR 1.800, 95% CI 1.086-2.984, p = 0.023) and heart failure (OR 2.410 95% CI 1.385-4.193, p = 0.002) independently predicted thrombotic events in this population. This study suggests that the P/F ratio is associated with thrombotic events by promoting a hypercoagulation state in patients hospitalized for COVID-19.
Keywords: Albumin; COVID-19; P/F ratio; Thrombosis.
. 2023 Jan 18.
doi: 10.1007/s11739-023-03196-w. Online ahead of print.
Association between PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio and thrombotic events in COVID-19 patients
Lorenzo Loffredo[SUP] 1 [/SUP], Pasquale Pignatelli[SUP] 2 [/SUP], Matteo Pirro[SUP] 3 [/SUP], Giancarlo Ceccarelli[SUP] 4 [/SUP], Alessandra Oliva[SUP] 4 [/SUP], Enrico Maggio[SUP] 2 [/SUP], Francesca Cancelli[SUP] 4 [/SUP], Damiano D'Ardes[SUP] 5 6 [/SUP], Maria Amitrano[SUP] 7 [/SUP], Anna Maria Zicari[SUP] 8 [/SUP], Bianca Laura Cinicola[SUP] 8 [/SUP], Gloria Taliani[SUP] 9 [/SUP], Roberto Cangemi[SUP] 9 [/SUP], Miriam Lichtner[SUP] 4 [/SUP], Marco Falcone[SUP] 10 [/SUP], Federica Orlando[SUP] 2 [/SUP], Francesco Pugliese[SUP] 4 [/SUP], Mario Venditti[SUP] 4 [/SUP], Claudio Maria Mastroianni[SUP] 4 [/SUP], Francesco Violi[SUP] 6 [/SUP]; COVID-Group
Collaborators, Affiliations
- PMID: 36650311
- DOI: 10.1007/s11739-023-03196-w
Abstract
PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] (P/F ratio) is considered a marker of hypoxia/hypoxemia and mortality. Several prothrombotic changes are associated with the decrease of P/F ratio. The role of P/F ratio in patients with arterial and venous thrombosis remains unclear. The aim of this study was to assess in patients with coronavirus disease 2019 (COVID-19), the association between P/F ratio and arterial/venous thrombosis. One thousand and four hundred and six COVID-19 patients were recruited; 289 (21%) patients had P/F ratio < 200 and 1117 (79%) ≥ 200. Compared to the patients with P/F ratio ≥ 200, those with P/F ratio < 200 were older and with higher levels of glycemia, D-dimer and lower levels of albumin. Multiple linear regression analysis showed that albumin (standardized coefficient β: 0.156; SE: 0.001; p = 0.0001) and D-dimer (standardized coefficient β: -0.135; SE: 0.0001; p = 0.0001) were associated with P/F ratio. During the hospitalization 159 patients were transferred in intensive care unit (ICU), 253 patients died, 156 patients had arterial or venous thrombotic events. A bivariate logistic analysis was performed to analyze the predictors of thrombosis in COVID-19 patients; P/F ratio < 200 (Odds Ratio: [OR] 1.718, 95% Confidence Interval [CI] 1.085-2.718, p = 0.021), albumin (OR 1.693, 95% CI 1.055-2.716, p = 0.029), D-dimer (OR 3.469, 95% CI 2.110-5.703, p < 0.0001), coronary artery disease (CAD) (OR 1.800, 95% CI 1.086-2.984, p = 0.023) and heart failure (OR 2.410 95% CI 1.385-4.193, p = 0.002) independently predicted thrombotic events in this population. This study suggests that the P/F ratio is associated with thrombotic events by promoting a hypercoagulation state in patients hospitalized for COVID-19.
Keywords: Albumin; COVID-19; P/F ratio; Thrombosis.