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Association between PaO2/FiO2 ratio and thrombotic events in COVID-19 patients.
Loffredo, Lorenzo; Pignatelli, Pasquale; Pirro, Matteo; Ceccarelli, Giancarlo; Oliva, Alessandra; Maggio, Enrico; Cancelli, Francesca; D'Ardes, Damiano; Amitrano, Maria; Zicari, Anna Maria; Cinicola, Bianca Laura; Taliani, Gloria; Cangemi, Roberto; Lichtner, Miriam; Falcone, Marco; Orlando, Federica; Pugliese, Francesco; Venditti, Mario; Mastroianni, Claudio Maria; Violi, Francesco.
  • Loffredo L; Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy. lorenzo.loffredo@uniroma1.it.
  • Pignatelli P; Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
  • Pirro M; Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
  • Ceccarelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Oliva A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Maggio E; Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
  • Cancelli F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • D'Ardes D; Clinica Medica, Department of Medicine and Aging, "G. D'Annunzio, University of Chieti-Pescara, Chieti, Italy.
  • Amitrano M; Mediterranea Cardiocentro-Napoli, Via Orazio, 2, 80122, Naples, Italy.
  • Zicari AM; Internal Medicine Unit, Moscati Hospital, Avellino, Italy.
  • Cinicola BL; Department of Maternal Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
  • Taliani G; Department of Maternal Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
  • Cangemi R; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Lichtner M; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Falcone M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Orlando F; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Pugliese F; Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
  • Venditti M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Mastroianni CM; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Violi F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Intern Emerg Med ; 18(3): 889-895, 2023 04.
Article in English | MEDLINE | ID: covidwho-2242832
ABSTRACT
PaO2/FiO2 (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 ß  0.156; SE 0.001; p = 0.0001) and D-dimer (standardized coefficient ß -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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Thrombophilia / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Intern Emerg Med Journal subject: Emergency Medicine / Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11739-023-03196-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Thrombophilia / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Intern Emerg Med Journal subject: Emergency Medicine / Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11739-023-03196-w