PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients

Yanli Gu, Donghui Wang, Cen Chen, Wanjun Lu, Hongbing Liu, Tangfeng Lv, Yong Song, Fang Zhang, Yanli Gu, Donghui Wang, Cen Chen, Wanjun Lu, Hongbing Liu, Tangfeng Lv, Yong Song, Fang Zhang

Abstract

To identify the risk factors of mortality for the coronavirus disease 19 (COVID-19) patients admitted to intensive care units (ICUs) through a retrospective analysis. The demographic, clinical, laboratory, and chest imaging data of patients admitted to the ICU of Huoshenshan Hospital from February 10 to April 10, 2020 were retrospectively analyzed. Student's t-test and Chi-square test were used to compare the continuous and categorical variables, respectively. The logistic regression model was employed to ascertain the risk factors of mortality. This retrospective study involved 123 patients, including 64 dead and 59 survivors. Among them, 57 people were tested for interleukin-6 (IL-6) (20 died and 37 survived). In all included patients, the oxygenation index (PaO2/FiO2) was identified as an independent risk factor (odd ratio [OR] = 0.96, 95% confidence interval [CI]: 0.928-0.994, p = 0.021). The area under the curve (AUC) was 0.895 (95% CI: 0.826-0.943, p < 0.0001). Among the patients tested for IL-6, the PaO2/FiO2 (OR = 0.955, 95%CI: 0.915-0.996, p = 0.032) and IL-6 (OR = 1.013, 95%CI: 1.001-1.025, p = 0.028) were identified as independent risk factors. The AUC was 0.9 (95% CI: 0.791-0.964, p < 0.0001) for IL-6 and 0.865 (95% CI: 0.748-0.941, p < 0.0001) for PaO2/FiO2. PaO2/FiO2 and IL-6 could potentially serve as independent risk factors for predicting death in COVID-19 patients requiring intensive care.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The AUC of PaO2/FiO2 in all patients (AUC = 0.895 (95% CI: 0.826–0.943, p < 0.0001)). Abbreviations: AUC: area under the curve; PaO2/FiO2: oxygenation index.
Figure 2
Figure 2
The AUC of IL-6 and PaO2/FiO2 and their combination in patients tested for IL-6. The AUC of IL-6 and PaO2/FiO2 were 0.9 (95% CI: 0.791–0.964, p < 0.0001) and 0.865 (95% CI: 0.748–0.941, p < 0.0001) respectively. The combination ROC curve of IL-6 and PaO2/FiO2 had an AUC of 0.936 (95%CI: 0.839–0.984), which were not statistically significant when compared with IL-6 (p = 0.319) or PaO2/FiO2 (p = 0.0502). Abbreviations: AUC: area under the curve; PaO2/FiO2: oxygenation index; IL-6: interleukin-6.
Figure 3
Figure 3
The variation trend of IL-6 levels in six patients (3 in deceased group and 3 in surviving group) during hospitalization. Abbreviations: IL-6: interleukin-6.

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