Continuous Monitoring Enables Dynamic Biomarkers to Assess Resilience in Acute COVID-19 Patients

Area of Science:

• Physiology
• Biomarkers
• Critical Care Medicine

Background:

• Effective management of acute illnesses like COVID-19 necessitates dynamic assessment of patient resilience.
• Continuous blood oxygen saturation (SpO2) monitoring offers potential for novel dynamic biomarkers.
• Assessing SpO2 regulation efficiency can aid clinical decision-making in acute care.

Purpose of the Study:

• To evaluate novel dynamic biomarkers derived from continuous SpO2 monitoring.
• To explore the association between these biomarkers and adverse hospital outcomes in COVID-19 patients.
• To support clinical decision-making through enhanced patient monitoring.

Main Methods:

• Analysis of 200 hospital admissions from 181 adult COVID-19 patients.
• Development of two dynamic SpO2 biomarkers: resilience exponent (α) and O2 challenge response.
• Binary logistic regression used to assess association with ICU admission or death.

Main Results:

• Increased resilience exponent α correlated with reduced odds of adverse outcomes (OR=0.59).
• Larger SpO2 increases during oxygen supplementation were linked to higher odds of adverse outcomes (OR=1.40).
• Frequency of oxygen supplementation adjustments independently predicted outcomes (increases: OR=2.91, decreases: OR=0.33).

Conclusions:

• The resilience exponent α and O2 challenge response reflect physical resilience in COVID-19 patients.
• These dynamic SpO2 biomarkers offer insights into homeostatic regulation.
• Continuous SpO2 monitoring can enhance clinical decision-making in acute care settings.