Can Increased Carbon Dioxide Gradient be Used as a Sensitive Bio-marker for COVID-19 Pneumonia Severity: An Indian Study

Abstract

Abstract Background: Acute respiratory distress syndrome caused by severe acute respiratory syndrome coronavirus 2, is a challenge to health-care system in the recent times. The nonavailability of specific treatment and rapid spread through aerosols has impacted the countries worldwide. Research on the subject is continuous, to understand the pathology and pathophysiology of the condition. In this regard, diagnosis of the disease, severity stratification and clinical prognostication helps the clinician to plan the management. Literature is silent on clinical biomarkers for this novel disease. Hence, a study was carried out to find out a suitable clinical biomarker for the disease. Methodology: The author carried out a retrospective analysis of the fatal case records of a tertiary center COVID intensive care unit to evaluate whether Carbon dioxide gradient can be used as an end-stage marker of COVID pneumonia. A record-based observational study was conducted and data were collected from the fatal case documents after an institutional ethical committee clearance. Results: A total of 42 fatal cases were analyzed. Carbon dioxide retention was found in more than 90% of cases and raised carbon dioxide gradient (>5 mmHg) was found in more than 50% of cases. The average days of mechanical ventilation was 9 days and on average, after 5 days of ventilation patients developed raised carbon dioxide gradient. Conclusion: We conclude that raised carbon dioxide gradient may be chosen as an end-stage marker for COVID pneumonia though large group studies are recommended.