Evidence map›Paper›PMID 35933689›Full record

ArticleRespirology (Carlton, Vic.)2022

Breath-holding physiology, radiological severity and adverse outcomes in COVID-19 patients: A prospective validation study.

Ludovico Messineo, Francesco Fanfulla, Leonardo Pedroni, Floriana Pini, Andrea Borghesi, Salvatore Golemi, Guido Vailati, Kayla Kerlin, Atul Malhotra, Luciano Corda and 1 more

Open access · bronzeAbstract read
In one paragraph

Article in Respirology (Carlton, Vic.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 4 countries.

Ludovico MessineoDivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-4142-9124
Francesco FanfullaSleep Medicine and Respiratory Function Unit, Maugeri Clinical and Scientific Institutes IRCCS, Pavia, Italy.
Leonardo PedroniRespiratory Medicine and Sleep Laboratory, Department of Experimental and Clinical Sciences, University of Brescia and Spedali Civili, Brescia, Italy.
Floriana PiniDepartment of General Medicine, Mellini Hospital, Italy.
Andrea BorghesiDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Salvatore GolemiDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Guido VailatiRespiratory Medicine and Sleep Laboratory, Department of Experimental and Clinical Sciences, University of Brescia and Spedali Civili, Brescia, Italy.
Kayla KerlinDivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Atul MalhotraDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, California, USA.
Luciano CordaRespiratory Medicine and Sleep Laboratory, Department of Experimental and Clinical Sciences, University of Brescia and Spedali Civili, Brescia, Italy.
Scott SandsDivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia · ITBrigham and Women's Hospital · USUniversity of Brescia · ITIstituti Clinici Scientifici Maugeri · ITMalacca General Hospital · MYUniversity of California System · US

Funding

Is Obstructive Sleep Apnea Important in the Development of Alzheimer's DiseaseR01AG063925 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2020 to 2024
$3.7M
Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
Underlying mechanisms of obesity-induced obstructive sleep apneaR01HL148436 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Atul Malhotra · 2020 to 2026
$3.4M
A Novel Pharmacological Therapy for Obstructive Sleep ApneaR01HL146697 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SANDS, SCOTT A · 2019 to 2023
$3.4M
Sleep Apnea Endophenotypes: One Size Does Not Fit AllR01HL154926 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2021 to 2025
$3.3M
VentNet: A Real-Time Multimodal Data Integration Model for Prediction of Respiratory Failure in Patients with COVID-19R01HL157985 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL, NEMATI, SHAMIM · 2022 to 2025
$2.9M
Training in the Next Generation in Respiratory ScienceT32HL134632 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL, POWELL, FRANK L. · 2017 to 2021
$2.1M
Assessment of Upper Airway Mechanics Using Newer Electromyographic TechniquesK24HL132105 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2016 to 2020
$611k
NHLBI NIH HHS K24 HL132105NHLBI NIH HHS R01 HL085188NHLBI NIH HHS R01 HL146697NHLBI NIH HHS R01 HL148436NHLBI NIH HHS R01 HL154926NHLBI NIH HHS R01 HL157985NHLBI NIH HHS T32 HL134632NIA NIH HHS R01 AG063925
6 · The paper itself

Abstract

BACKGROUND AND

objectiveCOVID-19 remains a major cause of respiratory failure, and means to identify future deterioration is needed. We recently developed a prediction score based on breath-holding manoeuvres (desaturation and maximal duration) to predict incident adverse COVID-19 outcomes. Here we prospectively validated our breath-holding prediction score in COVID-19 patients, and assessed associations with radiological scores of pulmonary involvement.

methodsHospitalized COVID-19 patients (N = 110, three recruitment centres) performed breath-holds at admission to provide a prediction score (Messineo et al.) based on mean desaturation (20-s breath-holds) and maximal breath-hold duration, plus baseline saturation, body mass index and cardiovascular disease. Odds ratios for incident adverse outcomes (composite of bi-level ventilatory support, ICU admission and death) were described for patients with versus without elevated scores (>0). Regression examined associations with chest x-ray (Brixia score) and computed tomography (CT; 3D-software quantification). Additional comparisons were made with the previously-validated '4C-score'.

resultsElevated prediction score was associated with adverse COVID-19 outcomes (N = 12/110), OR[95%CI] = 4.54[1.17-17.83], p = 0.030 (positive predictive value = 9/48, negative predictive value = 59/62). Results were diminished with removal of mean desaturation from the prediction score (OR = 3.30[0.93-11.72]). The prediction score rose linearly with Brixia score (β[95%CI] = 0.13[0.02-0.23], p = 0.026, N = 103) and CT-based quantification (β = 1.02[0.39-1.65], p = 0.002, N = 45). Mean desaturation was also associated with both radiological assessment. Elevated 4C-scores (≥high-risk category) had a weaker association with adverse outcomes (OR = 2.44[0.62-9.56]).

conclusionAn elevated breath-holding prediction score is associated with almost five-fold increased adverse COVID-19 outcome risk, and with pulmonary deficits observed in chest imaging. Breath-holding may identify COVID-19 patients at risk of future respiratory failure.

Indexed as

COVID-19Respiratory InsufficiencyHumansLungRetrospective StudiesSARS-CoV-2Tomography, X-Ray Computedbreath-holding procedurecoronavirus diseaseCOVID-19incident adverse outcomemean desaturationphysiologyradiological severity

Identifiers

PMID35933689
PMCPMC9539071
OpenAlexW4290420473

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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.