Abstract

Background: SARS CoV-2 known as COVID-19 spreads rapidly achieve effective and sustainable human-to-human transmission by contact, droplets, and possible airborne routes. Respiratory failure is one of the deadliest manifestations with poor prognosis related comorbidity. Predictor of the deterioration is useful for making decisions on the management of oxygen administration from non-invasive to invasive ventilation. Studies report the SaO2/FiO2 ratio is a reliable method to predict the mortality rate in COVID-19 infection. Aim: In this meta-analysis, we will measure the Sao2/FiO2 ratio as a predictor of mortality in COVID-19 infection. Methods: We included all research articles in adult patients diagnosed with COVID-19 with information on SaO2/FiO2 ratio available. The SaO2/FiO2 ratio (mmHg) is divided into non-severe (101-300) and severe (≤100). The mortality rate is defined in each SaO2/FiO2 ratio noticed in the first examination. Result: There were 850 patients included in this study. We separate the mild and moderate against severe SaO2/FiO2 ratio. The meta-analysis showed that there are no significant difference in both results (OR 1.06 [0.78 - 1.44], p = 0.69; I2: 95%, p<0.00001).Severity of respiratory failure in COVID-19 patient is important to determine the prognostic factor. COVID-19 is related to lung injury contribute to acute respiratory distress syndrome. From meta-analysis, we found no significant finding in SaO2/FiO2 ratio as a prognostic factor for mortality comparing mild and moderate to severe classification. No RCT study included and only 3 studies were analyzed. Further study and strong design are needed to prove this finding. Conclusion: SaO2/FiO2 ratio in COVID-19 infection cannot be used for the predictor of mortality when distinguished from mild to severe forms.

Keywords: SaO2/FiO2 ratio, Mortality rate, COVID-19