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An algorithm to predict the need for invasive mechanical ventilation in hospitalized COVID-19 patients: the

Eduardo Atsushi Osawa1,2, Alexandre Toledo Maciel1,2

  • 1Research Department, Imed Group, Sao Paulo, Brazil.

Acute and Critical Care
|October 6, 2022
PubMed

Insights

This study identified key predictors of invasive mechanical ventilation (IMV) in hospitalized COVID-19 patients, including male sex, age, obesity, and specific lab values. The findings aid in early risk stratification for critical respiratory support.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Epidemiology

Background:

  • Characterized hospitalized coronavirus disease 2019 (COVID-19) patients.
  • Aimed to identify predictors for invasive mechanical ventilation (IMV).

Purpose of the Study:

  • To characterize COVID-19 patients and identify predictors of IMV.
  • To develop a predictive model for IMV requirement in hospitalized patients.

Main Methods:

  • Retrospective cohort study of 1,650 COVID-19 patients in Sao Paulo, Brazil (March-October 2020).
  • Patients categorized into non-ICU, ICU without IMV, and ICU with IMV subgroups.
  • Logistic regression used to identify predictors of IMV.

Main Results:

  • Male sex, older age, obesity, and symptom duration were associated with IMV.
  • Key laboratory predictors included low arterial oxygen saturation, elevated C-reactive protein, neutrophil-to-lymphocyte ratio, and lactate dehydrogenase.
  • The prediction model demonstrated good performance with AUC values of 0.860 and 0.801 in development and validation cohorts, respectively.

Conclusions:

  • Distinct clinical and laboratory parameters differentiate COVID-19 patients early in hospital admission.
  • A predictive model can facilitate focused care for patients at high risk of requiring IMV.
Abstract

Keywords:
COVID-19SARSCoV-2algorithmcoronavirusintensive care unitsmechanical ventilation

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