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. 2023 Nov 14;9(4):262-270.
doi: 10.2478/jccm-2023-0030. eCollection 2023 Oct.

Study of Biochemical Parameters as Predictors for Need of Invasive Ventilation in Severely Ill COVID-19 Patients

Azmat Kamal Ansari  1 , Anjali Pitamberwale  2 , Shabana Andleeb Ansari  1 , Tariq Mahmood  3 , Kirti Limgaokar  4 , Geeta Karki  1 , Lalit Singh  1
Affiliations

Study of Biochemical Parameters as Predictors for Need of Invasive Ventilation in Severely Ill COVID-19 Patients

Azmat Kamal Ansari et al. J Crit Care Med (Targu Mures). .

Abstract

Background: Though laboratory tests have been shown to predict mortality in COVID-19, there is still a dearth of information regarding the role of biochemical parameters in predicting the type of ventilatory support that these patients may require.

Methods: The purpose of our retrospective observational study was to investigate the relationship between biochemical parameters and the type of ventilatory support needed for the intensive care of severely ill COVID-19 patients. We comprehensively recorded history, physical examination, vital signs from point-of-care testing (POCT) devices, clinical diagnosis, details of the ventilatory support required in intensive care and the results of the biochemical analysis at the time of admission. Appropriate statistical methods were used and P-values < 0.05 were considered significant. Receiver operating characteristics (ROC) analysis was performed and Area Under the Curve (AUC) of 0.6 to 0.7, 0.7 to 0.8, 0.8 to 0.9, and >0.9, respectively, were regarded as acceptable, fair, good, and exceptional for discrimination.

Results: Statistically significant differences (p<0.05) in Urea (p = 0.0351), Sodium (p = 0.0142), Indirect Bilirubin (p = 0.0251), Albumin (p = 0.0272), Aspartate Transaminase (AST) (p = 0.0060) and Procalcitonin (PCT) (p = 0.0420) were observed between the patients who were maintained on non-invasive ventilations as compared to those who required invasive ventilation. In patients who required invasive ventilation, the levels of Urea, Sodium, Indirect bilirubin, AST and PCT were higher while Albumin was lower. On ROC analysis, higher levels of Albumin was found to be acceptable indicator of maintenance on non-invasive ventilation while higher levels of Sodium and PCT were found to be fair predictor of requirement of invasive ventilation.

Conclusion: Our study emphasizes the role of biochemical parameters in predicting the type of ventilatory support that is needed in order to properly manage severely ill COVID-19 patients.

Keywords: acute respiratory distress syndrome; invasive ventilatory support; prognostic biochemical parameters; severely Ill COVID-19 patients.

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Conflict of interest statement

Conflict of interest None to declare.

Figures

Fig.1.
Fig.1.
ROC Curve of Total Protein, Albumin and Globulin as a predictor of Non-invasive Ventilation
Fig. 2.
Fig. 2.
ROC curve for Urea, Creatinine, Sodium and Potassium as an indicator of Invasive Ventilation
Fig. 3.
Fig. 3.
ROC curve for LDH and PCT as an indicator of Invasive Ventilation
Fig. 4.
Fig. 4.
ROC curve for IL-6, D-dimer and Ferritin as an indicator of Invasive Ventilation
See this image and copyright information in PMC

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