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. 2023 Feb;12(2):577-587.
doi: 10.1007/s40121-022-00752-3. Epub 2023 Jan 5.

The Association Between Alveolar-Arterial Oxygen Tension Difference and the Severity of COVID-19 in Patients

Canbin Xie  1 , Jiayi Deng  1 , Fanglin Li  1 , Chenfang Wu  1 , Min Xu  1 , Bo Yu  1 , Guobao Wu  1 , Yanjun Zhong  1 , Da Tang  2 , Jinxiu Li  3
Affiliations

The Association Between Alveolar-Arterial Oxygen Tension Difference and the Severity of COVID-19 in Patients

Canbin Xie et al. Infect Dis Ther. 2023 Feb.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) emerged as a global pandemic and resulted in a significantly high death toll. Therefore, there is an urgent need to find a potential biomarker related to the disease severity that can facilitate early-stage intervention.

Methods: In the present study, we collected 242 laboratory-confirmed COVID-19-infected patients. The patients were grouped according to the alveolar to arterial oxygen tension difference (PA-aO2) value of COVID-19 infection after admission.

Results: Among the 242 laboratory-confirmed COVID-19- infected patients, 155 (64.05%) had an abnormal PA-aO2 value on admission. Compared with the normal PA-aO2 group, the median age of the abnormal PA-aO2 group was significantly older (p = 0.032). Symptoms such as fever, cough, and shortness of breath were more obvious in the abnormal PA-aO2 group. The proportion of severe events in the abnormal PA-aO2 group was higher than the normal PA-aO2 group (10.34% vs. 23.23%, p = 0.013). The abnormal PA-aO2 group had a higher possibility of developing severe events compared with the normal PA-aO2 group (HR 2.622, 95% CI 1.197-5.744, p = 0.016). After adjusting for age and common comorbidities (hypertension and cardiovascular disease), the abnormal PA-aO2 group still exhibited significantly elevated risks of developing severe events than the normal PA-aO2 group (HR 2.986, 95% CI 1.220-7.309, p = 0.017). Additionally, the abnormal PA-aO2 group had more serious inflammation/coagulopathy/fibrinolysis parameters than the normal PA-aO2 group.

Conclusion: Abnormal PA-aO2 value was found to be common in COVID-19 patients, was strongly related to severe event development, and could be a potential biomarker for the prognosis of COVID-19 patients.

Keywords: Biomarker; COVID-19; PA-aO2; Prognosis; Severe event.

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