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Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID‐19: A multicentric prospective evaluation
Author(s) -
Di Bella Stefano,
Cesareo Roberto,
De Cristofaro Paolo,
Palermo Andrea,
Sanson Gianfranco,
RomanPognuz Erik,
Zerbato Verena,
Manfrini Silvia,
Giacomazzi Donatella,
Dal Bo Eugenia,
Sambataro Gianluca,
Macchini Elisabetta,
Quintavalle Francesco,
Campagna Giuseppe,
Masala Renato,
Ottaviani Luigi,
Del Borgo Cosmo,
Ridola Lorenzo,
Leonetti Frida,
Berlot Giorgio,
Luzzati Roberto
Publication year - 2021
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3354
Subject(s) - medicine , mechanical ventilation , prospective cohort study , body mass index , logistic regression , copd , anthropometry , diabetes mellitus , covid-19 , endocrinology , disease , infectious disease (medical specialty)
Aims COVID‐19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID‐19 inpatients. Materials and Methods We prospectively and consecutively enrolled COVID‐19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow‐up time was 30 days from hospital admission. Results We enrolled 132 subjects (55.0‐75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260—per 1 cm increase 95% CI:1.120‐1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m 2 (adjusted OR 1.526; 95% CI:1.243‐1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684‐0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log‐rank test: P < .001). Conclusions NC is an easy to measure parameter able to predict the need for IMV in adult COVID‐19 inpatients.