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Oxygen and Mortality in Covid-19 Pneumonia

A Comparative Analysis of Supplemental Oxygen Policies and Health Outcomes Across 26 Countries

Bibliographic Data

ID22085349
AuthorsFatma Mansab (Gibraltar Health Authority), Harry Donnelly (St Bernard's Hospital), Albrecht Kussner (St Bernard's Hospital), James Neil, Sohail Bhatti (Gibraltar Health Authority), Daniel K Goyal, Daniel Goyal (0000-0003-0418-8859, St Bernard's Hospital, corresponding author)
Year2021
Volume9
Pages580585-580585
Publication date2021-07-13
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.580585
PMID34327182
OpenAlexW3177571953
LanguageEN
Citations received2
References cited19

Introduction: Hypoxia is the main cause of morbidity and mortality in COVID-19. During the COVID-19 pandemic, some countries have reduced access to supplemental oxygen, whereas other nations have maintained and even improved access to supplemental oxygen. We examined whether variation in the nationally determined oxygen guidelines had any association with national mortality rates in COVID-19. Methods: Three independent investigators searched for, identified, and extracted the nationally recommended target oxygen levels for the commencement of oxygen in COVID-19 pneumonia from the 29 worst affected countries. Mortality estimates were calculated from three independent sources. We then applied both parametric (Pearson's R) and non-parametric (Kendall's Tau B) tests of bivariate association to determine the relationship between case fatality rate (CFR) and target SpO 2 , and also between potential confounders and CFR. Results: Of the 26 nations included, 15 had employed conservative oxygen strategies to manage COVID-19 pneumonia. Of them, Belgium, France, USA, Canada, China, Germany, Mexico, Spain, Sweden, and the UK guidelines advised commencing oxygen when oxygen saturations (SpO 2 ) fell to 91% or less. A statistically significant correlation was found between SpO 2 and CFR both parametrically ( R = −0.53, P < 0.01) and non-parametrically (−0.474, P < 0.01). Conclusion: Our study highlights the disparity in oxygen provision for COVID-19 patients between the nations analysed. In those nations that pursued a conservative oxygen strategy, there was an association with higher national mortality rates. We discuss the potential reasons for such an association

Case fatality rate · Confounding · Disease · Environmental health · Mortality rate · Oxygen · Pandemic · Population · Chemistry · COVID-19 Clinical Research Studies · Demography · Long-Term Effects of COVID-19 · Medicine · Respiratory Support and Mechanisms · Internal Medicine

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Citations per year0.5
Citation span2022 - 2023 (2)
Highly citedNo

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