Evaluation of pragmatic oxygenation measurement as a proxy for Covid-19 severity.

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Swets, Maaike C ORCID: 0000-0003-0901-9560, Kerr, Steven, Scott-Brown, James ORCID: 0000-0001-5642-8346, Brown, Adam B ORCID: 0009-0002-1270-928X, Gupta, Rishi ORCID: 0000-0002-6257-1285, Millar, Jonathan E, Spata, Enti, McCurrach, Fiona, Bretherick, Andrew D ORCID: 0000-0001-9258-3140, Docherty, Annemarie ORCID: 0000-0001-8277-420X et al (show 14 more authors) , Harrison, David, Rowan, Kathy ORCID: 0000-0001-8217-5602, Young, Neil, ISARIC4C Investigators, , Groeneveld, Geert H, Dunning, Jake, Nguyen-Van-Tam, Jonathan S ORCID: 0000-0003-2579-4655, Openshaw, Peter ORCID: 0000-0002-7220-2555, Horby, Peter W ORCID: 0000-0002-9822-1586, Harrison, Ewen ORCID: 0000-0002-5018-3066, Staplin, Natalie, Semple, Malcolm G ORCID: 0000-0001-9700-0418, Lone, Nazir ORCID: 0000-0003-2707-2779 and Baillie, J Kenneth ORCID: 0000-0001-5258-793X (2023) Evaluation of pragmatic oxygenation measurement as a proxy for Covid-19 severity. Nature communications, 14 (1). 7374-.

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Abstract

Choosing optimal outcome measures maximizes statistical power, accelerates discovery and improves reliability in early-phase trials. We devised and evaluated a modification to a pragmatic measure of oxygenation function, the [Formula: see text] ratio. Because of the ceiling effect in oxyhaemoglobin saturation, [Formula: see text] ratio ceases to reflect pulmonary oxygenation function at high [Formula: see text] values. We found that the correlation of [Formula: see text] with the reference standard ([Formula: see text]/[Formula: see text] ratio) improves substantially when excluding [Formula: see text] and refer to this measure as [Formula: see text]. Using observational data from 39,765 hospitalised COVID-19 patients, we demonstrate that [Formula: see text] is predictive of mortality, and compare the sample sizes required for trials using four different outcome measures. We show that a significant difference in outcome could be detected with the smallest sample size using [Formula: see text]. We demonstrate that [Formula: see text] is an effective intermediate outcome measure in COVID-19. It is a non-invasive measurement, representative of disease severity and provides greater statistical power.

Item Type:	Article
Uncontrolled Keywords:	ISARIC4C Investigators, Lung, Humans, Reproducibility of Results, Sample Size, COVID-19
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	17 Nov 2023 11:20
Last Modified:	02 Dec 2023 01:30
DOI:	10.1038/s41467-023-42205-6
Open Access URL:	https://doi.org/10.1038/s41467-023-42205-6
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3176853