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Rationale  Oxygen saturation to fraction of inspired oxygen ratio (SpO 2 /FiO 2 ) has been described as potential predictor of poor outcome for COVID-19, without considering its time-varying behavior though.    Methods  Prognostic value of SpO 2 /FiO 2  was evaluated by jointly modeling the longitudinal responses of SpO 2 /FiO 2  and time-to-event data retrieved from 280 severe and critically ill (intensive care) patients with COVID-19.    Results  A sharply decrease of SpO 2 /FiO 2  from the first to second measurement for non-survivors was observed, and a strong association between square root SpO 2 /FiO 2  and mortality risk was demonstrated, with a unit decrease in the marker corresponding to 1.82-fold increase in mortality risk (95% CI: 1.56–2.13).    Conclusions  The current study suggested that SpO 2 /FiO 2  could serve as a non-invasive prognostic marker to facilitate early adjustment for treatment, thus improving overall survival.

Continuously available ratio of SpO2/FiO2 serves as a noninvasive prognostic marker for intensive care patients with COVID-19