Observational studyBMJ open2020
Severity of respiratory failure at admission and in-hospital mortality in patients with COVID-19: a prospective observational multicentre study.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04307459 (Acute Respiratory Failure and Continuous Positive Airway Pressure Therapy in Patients With Severe Acute Respiratory Syndrome Coronavirus 2), which is not on this map. Cited by 62 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acute Respiratory Failure and Continuous Positive Airway Pressure Therapy in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: a Real Life Evaluation
Who cites it
62 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Rapid Evaluation of Coronavirus Illness Severity (RECOILS) in intensive care: Development and validation of a prognostic tool for in-hospital mortality.Acta anaesthesiologica Scandinavica · 2022Pooled it
- Coronavirus Disease 2019 as Cause of Viral Sepsis: A Systematic Review and Meta-Analysis.Critical care medicine · 2021Pooled it
- Efficacy and safety of hyperbaric oxygen treatment in SARS-COV-2 (COVID-19) pneumonia: a systematic review.Diving and hyperbaric medicine · 2021Pooled it
- Nutritional determinants and COVID-19 outcomes of older patients with COVID-19: A systematic review.Archives of gerontology and geriatricsPooled it
- Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial.Critical care (London, England) · 2023Trial
- An Inhaled Galectin-3 Inhibitor in COVID-19 Pneumonitis: A Phase Ib/IIa Randomized Controlled Clinical Trial (DEFINE).American journal of respiratory and critical care medicine · 2023Trial
- Trial
- Does a prior COVID-19 infection affect lung dynamics during thoracic anesthesia?BMC anesthesiology · 2026Article
- Exploring Racial Differences in Family Expressions of Emotion and Clinician Empathy in ICU Family Meetings.CHEST critical care · 2025Article
- The COVID-19 Pandemic and Goals-of-Care Conversations in Veterans Health Administration Clinics.JAMA network open · 2025Article
- Characterization of a SARS-CoV-2 infection model in golden hamsters with diabetes mellitus.Virologica Sinica · 2025Article
- Evaluating the impact of ESICM 2023 guidelines and the new global definition of ARDS on clinical outcomes: insights from MIMIC-IV cohort data.European journal of medical research · 2025Article
- Risk factors for in-hospital mortality in older patients with acute respiratory distress syndrome due to COVID-19: a retrospective cohort study.BMC geriatrics · 2024Observational
- Predictive value of invasive mechanical ventilation parameters for mortality in COVID-19 related ARDS: a retrospective cohort study.Scientific reports · 2024Observational
- Reinforcement learning for intensive care medicine: actionable clinical insights from novel approaches to reward shaping and off-policy model evaluation.Intensive care medicine experimental · 2024Article
- Hypoxia and Activation of Neutrophil Degranulation-Related Genes in the Peripheral Blood of COVID-19 Patients.Viruses · 2024Article
- Prediction of COVID-19 in-hospital mortality in older patients using artificial intelligence: a multicenter study.Frontiers in aging · 2024Article
- Association between (ΔPaO2/FiO2)/PEEP and in-hospital mortality in patients with COVID-19 pneumonia: A secondary analysis.PloS one · 2024Article
- Correlation between oxygenation function and laboratory indicators in COVID-19 patients based on non-enhanced chest CT images and construction of an artificial intelligence prediction model.Frontiers in microbiology · 2024Article
- QTc Prolongation to Predict Mortality in Patients Admitted with COVID-19 Infection: An Observational Study.Current vascular pharmacology · 2024Observational
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCOVID-19 causes lung parenchymal and endothelial damage that lead to hypoxic acute respiratory failure (hARF). The influence of hARF severity on patients' outcomes is still poorly understood.
designObservational, prospective, multicentre study.
settingThree academic hospitals in Milan (Italy) involving three respiratory high dependency units and three general wards.
participantsConsecutive adult hospitalised patients with a virologically confirmed diagnosis of COVID-19. Patients aged <18 years or unable to provide informed consent were excluded.
interventionsAnthropometrical, clinical characteristics and blood biomarkers were assessed within the first 24 hours from admission. hARF was graded as follows: severe (partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2/FiO2) <100 mm Hg); moderate (PaO2/FiO2 101-200 mm Hg); mild (PaO2/FiO2 201-300 mm Hg) and normal (PaO2/FiO2 >300 mm Hg). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the assessment of clinical characteristics and in-hospital mortality based on the severity of respiratory failure. Secondary outcomes were intubation rate and application of continuous positive airway pressure during hospital stay.
results412 patients were enrolled (280 males, 68%). Median (IQR) age was 66 (55-76) years with a PaO2/FiO2 at admission of 262 (140-343) mm Hg. 50.2% had a cardiovascular disease. Prevalence of mild, moderate and severe hARF was 24.4%, 21.9% and 15.5%, respectively. In-hospital mortality proportionally increased with increasing impairment of gas exchange (p<0.001). The only independent risk factors for mortality were age ≥65 years (HR 3.41; 95% CI 2.00 to 5.78, p<0.0001), PaO2/FiO2 ratio ≤200 mm Hg (HR 3.57; 95% CI 2.20 to 5.77, p<0.0001) and respiratory failure at admission (HR 3.58; 95% CI 1.05 to 12.18, p=0.04).
conclusionsA moderate-to-severe impairment in PaO2/FiO2 was independently associated with a threefold increase in risk of in-hospital mortality. Severity of respiratory failure is useful to identify patients at higher risk of mortality. TRIAL REGISTRATION NUMBER: NCT04307459.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.