Background: The coronavirus disease 2019 (COVID-19) results in hypoxia in around a fifth of adult patients. Severe hypoxia in the absence of visible respiratory distress (‘silent hypoxia’) is increasingly recognised in these patients. There are no published data evaluating lowest recorded pre-hospital oxygen saturation or pre-hospital National Early Warning Score 2 (NEWS2) as a predictor of outcome in patients with COVID-19. Methods: In this retrospective service evaluation, we included adult inpatients with laboratory confirmed COVID-19 who were discharged from hospital or who died in hospital between 12 March and 28 April 2020 (n = 143). Pre-hospital and in-hospital data were extracted and analysed to explore risk factors associated with in-hospital mortality to inform local triage and emergency management. Results: The lowest recorded pre-hospital oxygen saturation was an independent predictor of mortality when controlling for age, gender and history of COPD. A 1% reduction in pre-hospital oxygen saturation increased the odds of death by 13% (OR 1.13, p < 0.001). Lower pre-hospital oxygen saturation predicted mortality after adjusting for the pre-hospital NEWS2 (OR for a 1% reduction in pre-hospital oxygen saturation 1.09, p = 0.02). The pre-hospital NEWS2 was higher in those who died (Median 9; IQR 7-10; n = 24) than in those who survived to discharge (Median 6; IQR 5-8; n = 63). Conclusion: This service evaluation suggests that the lowest recorded pre-hospital oxygen saturation may be an independent predictor of mortality in COVID-19 patients. Lowest pre-hospital oxygen saturation should be recorded and used in the assessment of patients with suspected COVID-19 in pre-hospital and emergency department triage settings.
【저자키워드】 COVID-19, coronavirus, Respiratory failure, Triage, oxygen saturation, NEWS2, 【초록키워드】 coronavirus disease, Mortality, hypoxia, hospital, Gender, Local, outcome, risk factor, discharge, COPD, Laboratory, management, Patient, death, age, patients, score, in-hospital mortality, COVID-19 patients, retrospective, distress, In-hospital, Inpatient, Lower, independent, lowest, predicted, died, analysed, absence, reduction in, discharged, recorded, increasingly, IQR, patients with COVID-19, those who survived, 【제목키워드】 death, predict, lowest, recorded, patients with COVID-19,