Abstract
BackgroundMuch effort has been placed on evaluating serological tests that can predict worsening prognosis in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Endotracheal intubation in SARS-CoV-2 is associated with a higher risk of mortality. While studies have evaluated serological markers that can predict worsening prognosis, the likelihood of intubation in these patients has not been evaluated. The objective of this study was to determine if any serum marker corresponded to oxygen escalation or de-escalation in SARS-CoV-2-infected pre-intubated patients.MethodologyThis retrospective study reviewed 1,754 SARS-CoV-2 patients in the New York City Health and Hospitals Corporation (NYCHHC) system who required non-invasive positive pressure ventilation (NIPPV) such as continuous positive airway pressure or bilevel positive airway pressure. All patients were above the age of 18, were not terminally ill and requiring hospice care, and were admitted to the NYCHHC system between March 1, 2020 and May 17, 2020. SARS-CoV-2 serological labs were collected for five days for patients initiated on NIPPV, such that day one was 24 hours after NIPPV initiation.ResultsMultivariate and univariate linear regression modeling on this population cohort was remarkable for a significant association between serum albumin levels and oxygen escalation or de-escalation from NIPPV.ConclusionsWe conclude that serum albumin level may have further utility in predicting oxygen escalation in pre-intubated patients with SARS-CoV-2, especially in a low-resource and high-demand setting.
Highlights
In light of increasing morbidity and mortality from severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, much effort has been placed on evaluating serological biomarkers that can predict worsening prognosis
Multivariate and univariate linear regression modeling on this population cohort was remarkable for a significant association between serum albumin levels and oxygen escalation or de-escalation from non-invasive positive pressure ventilation (NIPPV)
We conclude that serum albumin level may have further utility in predicting oxygen escalation in preintubated patients with SARS-CoV-2, especially in a low-resource and high-demand setting
Summary
In light of increasing morbidity and mortality from severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, much effort has been placed on evaluating serological biomarkers that can predict worsening prognosis. Endotracheal intubation in SARS-CoV-2 has been associated with a higher risk of mortality [4], and determining an efficient way of identifying patients who are likely to require intubation would assist in providing enhanced care and prioritizing resources in a high-demand and limited-resource setting [5]. Much effort has been placed on evaluating serological tests that can predict worsening prognosis in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. While studies have evaluated serological markers that can predict worsening prognosis, the likelihood of intubation in these patients has not been evaluated. The objective of this study was to determine if any serum marker corresponded to oxygen escalation or deescalation in SARS-CoV-2-infected pre-intubated patients
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