open access

Ahead of Print
Research paper
Published online: 2020-12-17
Submitted: 2020-07-22
Accepted: 2020-10-19
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Validity of ROX index in prediction of risk of intubation in patients with COVID-19 pneumonia

Lucy Abdelmabood Suliman, Taha Taha Abdelgawad, Nesrine Saad Farrag, Heba Wagih Abdelwahab
DOI: 10.5603/ARM.a2020.0176

open access

Ahead of Print
ORIGINAL PAPERS
Published online: 2020-12-17
Submitted: 2020-07-22
Accepted: 2020-10-19

Abstract

Introduction: One important concern during the management of COVID-19 pneumonia patients with acute hypoxemic respiratory failure is early anticipation of the need for intubation. ROX is an index that can help in identification of patients with low and those with high risk of intubation. So, this study was planned to validate the diagnostic accuracy of the ROX index for prediction of COVID-19 pneumonia outcome (the need for intubation) and, in addition, to underline the significant association of the ROX index with clinical, radiological, demographic data.
Material and methods: Sixty-nine RT-PCR positive COVID-19 patients were enrolled. The following data were collected: medical history, clinical classification of COVID-19 infection, the ROX index measured daily and the outcome assessment.
Results: All patients with severe COVID-19 infection (100%) were intubated (50% of them on the 3rd day of admission), but only 38% of patients with moderate COVID-19 infection required intubation (all of them on the 3rd day of admission). The ROX index on the 1st day of admission was significantly associated with the presence of comorbidities, COVID-19 clinical classification, CT findings and intubation (p ≤ 0.001 for each of them). Regression analysis showed that sex and ROX.1 are the only significant independent predictors of intubation [AOR (95% CI): 16.9 (2.4– 117), 0.77 (0.69–0.86)], respectively. Cut-off point of the ROX index on the 1st day of admission was ≤ 25.26 (90.2% of sensitivity and 75% of specificity).
Conclusions: ROX is a simple noninvasive promising tool for predicting discontinuation of high-flow oxygen therapy and could be used in the assessment of progress and the risk of intubation in COVID-19 patients with pneumonia.

Abstract

Introduction: One important concern during the management of COVID-19 pneumonia patients with acute hypoxemic respiratory failure is early anticipation of the need for intubation. ROX is an index that can help in identification of patients with low and those with high risk of intubation. So, this study was planned to validate the diagnostic accuracy of the ROX index for prediction of COVID-19 pneumonia outcome (the need for intubation) and, in addition, to underline the significant association of the ROX index with clinical, radiological, demographic data.
Material and methods: Sixty-nine RT-PCR positive COVID-19 patients were enrolled. The following data were collected: medical history, clinical classification of COVID-19 infection, the ROX index measured daily and the outcome assessment.
Results: All patients with severe COVID-19 infection (100%) were intubated (50% of them on the 3rd day of admission), but only 38% of patients with moderate COVID-19 infection required intubation (all of them on the 3rd day of admission). The ROX index on the 1st day of admission was significantly associated with the presence of comorbidities, COVID-19 clinical classification, CT findings and intubation (p ≤ 0.001 for each of them). Regression analysis showed that sex and ROX.1 are the only significant independent predictors of intubation [AOR (95% CI): 16.9 (2.4– 117), 0.77 (0.69–0.86)], respectively. Cut-off point of the ROX index on the 1st day of admission was ≤ 25.26 (90.2% of sensitivity and 75% of specificity).
Conclusions: ROX is a simple noninvasive promising tool for predicting discontinuation of high-flow oxygen therapy and could be used in the assessment of progress and the risk of intubation in COVID-19 patients with pneumonia.

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Keywords

ROX index; COVIID-19; intubation risk

About this article
Title

Validity of ROX index in prediction of risk of intubation in patients with COVID-19 pneumonia

Journal

Advances in Respiratory Medicine

Issue

Ahead of Print

Article type

Research paper

Published online

2020-12-17

DOI

10.5603/ARM.a2020.0176

Keywords

ROX index
COVIID-19
intubation risk

Authors

Lucy Abdelmabood Suliman
Taha Taha Abdelgawad
Nesrine Saad Farrag
Heba Wagih Abdelwahab

References (10)
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