Performance of oxygenation indices and risk scores to predict invasive mechanical ventilation and mortality in COVID-19.

BACKGROUND: Information on the performance of oxygenation indices (OIs) and risk scores in patients requiring invasive mechanical ventilation (IMV) is limited. We determine the performance of the OIs and risk scores in hospitalized patients with COVID-19 to predict the requirement of IMV and death at 28 days after admission. METHODS: A retrospective study of diagnostic tests in patients admitted to the emergency department, hospitalization, and intensive care unit diagnosed with COVID-19. The receiver operating characteristic curve (ROC-curve) were built with the OIs and risk scores to predict IMV and mortality. RESULTS: A total of 1402 subjects entered the final analysis, of whom 19.5% (274/1402) received IMV and 23.0% (323/1402) died at 28 days. The ROC-curve of the delta PaO2/FiO2 ratio for the requirement of IMV and mortality at 28-day was 0.589 (95% CI: 0.546-0.632) and 0.567 (95% CI: 0.526-0.608), respectively. PaO2/FiO2 ≤ 300 shows a ROC curve of 0.669 (95% CI: 0.628-0.711) to predict IMV. PaO2/FiO2 ≤ 300 and 4 C mortality score in mortality at 28 days showed an ROC-curve of 0.624 (95% CI: 0.582-0.667) and 0.706 (95% CI: 0.669-0.742), respectively. CONCLUSION: PaO2/FiO2 ≤ 300, 4 C mortality score ≥ 8, SOFA score ≥ 4 y SaO2/FiO2 ≤ 300 were weak predictors of the IMV requirement from admission, and 4 C mortality score ≥ 8 was weak predictors of the mortality from admission in patients with pulmonary involvement by COVID-19.

[Chemical contamination of the child: bioacumulation and potential effects]. / Contaminación química en la infancia: bioacumulación y efectos potenciales.

In early 2003, Greenpeace exposed the presence of persistent, bioaccumulative chemical pollutants in samples of house dust taken from homes across europe. Greenpeace further researches revealed that these same chemicals can be found in many daily consumer products. This report completes the loop by illustrating two disturbing developments. Firstly, that many of the same chemicals used routinely in consumer products and present in house dust, are also present in the human body, including in prenatal and newborn children. Secondly, that these chemicals are likely to be having a detrimental effect on the health of children and the human population at large. Dorey draws together the available evidence that illustrates how and why prenatal and newly born children are particularly at risk from chemical pollutants. The evidence presented here, from academics, governments and international institutions is not easily dismissed, contributing as it does to a growing bank of international research that reinforces the conclusion of this report--that current chemical legislation is failing to protect children from a harmful chemical assault that begins from a child's conception. The study focuses on seven key chemicals: alkylphenols, bisphenol A, brominated flame retardants, organotins, phthalates, chlorinated paraffins and artificial musks, and demonstrates: the presence of these substances in children, the ways in which children are particularly exposed, how this increased exposure increases the potential for detrimental health impacts, the different illnesses and diseases that are now being linked to this chemical exposure and the specific health impacts of the key chemicals listed above.