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Abstract
PURPOSE: We aimed to assess the effect of hemoglobin (Hb) concentration and oxygenation index on COVID-19 patients' mortality risk.
PATIENTS AND METHODS: We retrospectively reviewed sociodemographic and clinical characteristics, laboratory findings, and clinical outcomes from patients admitted to a tertiary care hospital in Bogotá, Colombia, from March to July 2020. We assessed exploratory associations between oxygenation index and Hb concentration at admission and clinical outcomes. We used a generalized additive model (GAM) to evaluate the observed nonlinear relations and the classification and regression trees (CART) algorithm to assess the interaction effects.
RESULTS: We included 550 patients, of which 52% were male. The median age was 57 years old, and the most frequent comorbidity was hypertension (29%). The median value of SpO2/FiO2 was 424, and the median Hb concentration was 15 g/dL. The mortality was 15.1% (83 patients). Age, sex, and SpO2/FiO2, were independently associated with mortality. We described a nonlinear relationship between Hb concentration and neutrophil-to-lymphocyte ratio with mortality and an interaction effect between SpO2/FiO2 and Hb concentration. Patients with a similar oxygenation index had different mortality likelihoods based upon their Hb at admission. CART showed that patients with SpO2/FiO2 < 324, who were less than 81 years with an NLR >9.9, and Hb > 15 g/dl had the highest mortality risk (91%). Additionally, patients with SpO2/FiO2 > 324 but Hb of < 12 g/dl and a history of hypertension had a higher mortality likelihood (59%). In contrast, patients with SpO2/FiO2 > 324 and Hb of > 12 g/dl had the lowest mortality risk (9%).
CONCLUSION: We found that a decreased SpO2/FiO2 increased mortality risk. Extreme values of Hb, either low or high, showed an increase in the likelihood of mortality. However, Hb concentration modified the SpO2/FiO2 effect on mortality; the probability of death in patients with low SpO2/FiO2 increased as Hb increased.
Original language | English |
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Pages (from-to) | 6965-6976 |
Number of pages | 12 |
Journal | International journal of general medicine |
Volume | 15 |
DOIs | |
State | Published - 2022 |
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Dive into the research topics of 'Interaction Effect Between Hemoglobin and Hypoxemia on COVID-19 Mortality: an observational study from Bogotá, Colombia'. Together they form a unique fingerprint.Projects
- 2 Finished
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Mortality due to Acute Respiratory Distress Syndrome secondary to COVID 19, using the formula adjusted for the height of Berlin in the city of Bogotá
Rodríguez-Lima, D. (PI), Pinilla-Rojas, D. (CoI), Rubio-Ramos, C. (CoI), Ruiz-Sternberg, A. M. (CoI), Pinzón, Á. (CoI), Molano Gonzalez, N. (CoI) & Pardo Oviedo, J. M. (CoI)
17/12/21 → 17/12/22
Project: Research › Clinical Research
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Description of the incidence, oxygenation indices and clinical outcomes in patients with Acute Respiratory Distress Syndrome (ARDS) at 2600 meters of altitude in COVID
Rodríguez-Lima, D. (PI), Pinzón, Á. (PI), Ruiz-Sternberg, A. M. (CoI), Rubio-Ramos, C. (CoI), Pinilla-Rojas, D. (CoI), Molano-Gonzalez, N. (PI), Pardo-Oviedo, J. M. (PI) & Shafazand, S. (CoI)
1/04/20 → 12/12/22
Project: Research › Clinical Research