• Intern Emerg Med · Apr 2023

    Association between PaO2/FiO2 ratio and thrombotic events in COVID-19 patients.

    • Lorenzo Loffredo, Pasquale Pignatelli, Matteo Pirro, Giancarlo Ceccarelli, Alessandra Oliva, Enrico Maggio, Francesca Cancelli, Damiano D'Ardes, Maria Amitrano, Anna Maria Zicari, Bianca Laura Cinicola, Gloria Taliani, Roberto Cangemi, Miriam Lichtner, Marco Falcone, Federica Orlando, Francesco Pugliese, Mario Venditti, Claudio Maria Mastroianni, Francesco Violi, and COVID-Group.
    • Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy. lorenzo.loffredo@uniroma1.it.
    • Intern Emerg Med. 2023 Apr 1; 18 (3): 889895889-895.

    AbstractPaO2/FiO2 (P/F ratio) is considered a marker of hypoxia/hypoxemia and mortality. Several prothrombotic changes are associated with the decrease of P/F ratio. The role of P/F ratio in patients with arterial and venous thrombosis remains unclear. The aim of this study was to assess in patients with coronavirus disease 2019 (COVID-19), the association between P/F ratio and arterial/venous thrombosis. One thousand and four hundred and six COVID-19 patients were recruited; 289 (21%) patients had P/F ratio < 200 and 1117 (79%) ≥ 200. Compared to the patients with P/F ratio ≥ 200, those with P/F ratio < 200 were older and with higher levels of glycemia, D-dimer and lower levels of albumin. Multiple linear regression analysis showed that albumin (standardized coefficient β:  0.156; SE: 0.001; p = 0.0001) and D-dimer (standardized coefficient β: -0.135; SE: 0.0001; p = 0.0001) were associated with P/F ratio. During the hospitalization 159 patients were transferred in intensive care unit (ICU), 253 patients died, 156 patients had arterial or venous thrombotic events. A bivariate logistic analysis was performed to analyze the predictors of thrombosis in COVID-19 patients; P/F ratio < 200 (Odds Ratio: [OR] 1.718, 95% Confidence Interval [CI] 1.085-2.718, p = 0.021), albumin (OR 1.693, 95% CI 1.055-2.716, p = 0.029), D-dimer (OR 3.469, 95% CI 2.110-5.703, p < 0.0001), coronary artery disease (CAD) (OR 1.800, 95% CI 1.086-2.984, p = 0.023) and heart failure (OR 2.410 95% CI 1.385-4.193, p = 0.002) independently predicted thrombotic events in this population. This study suggests that the P/F ratio is associated with thrombotic events by promoting a hypercoagulation state in patients hospitalized for COVID-19.© 2023. The Author(s).

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