Background: This study aimed to determine parameters for worsening oxygenation in non-severe COVID-19 pneumonia .
Methods: This retrospective cohort study included confirmed COVID-19 pneumonia in a public hospital in South Korea . The worsening oxygenation group was defined as those with SpO2 & #8804; 94%, or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening group who were without any respiratory event . Parameters were compared, and the extent of viral pneumonia from an initial chest CT were calculated using artificial intelligence (AI) and measured visually by a radiologist .
Results: We included 136 patients with 32 (23.5 %) in the worsening oxygenation group, of whom two needed MV and one died . Initial vital signs and duration of symptoms showed no difference between the two groups, however, univariate logistic regression analysis revealed that a variety of parameters at admission were associated with an increased risk of a desaturation event . A subset of patients were studied to eliminate potential bias, that ferritin & #8805; 280 µg/L (p=0.029), LDH & #8805; 240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study presents initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation at admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.