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Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity

OBJECTIVE: To assess the feasibility of Fractional exhaled Nitric Oxide (FeNO) as a simple, non-invasive, cost-effective and portable biomarker and decision support tool for risk stratification of COVID-19 patients. METHODS: We conducted a single-center prospective cohort study of COVID-19 patients...

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Autores principales: Lior, Yotam, Yatzkan, Noga, Brami, Ido, Yogev, Yuval, Riff, Reut, Hekselman, Idan, Fremder, Moran, Freixo-Lima, Gabriella, Be'er, Moria, Amirav, Israel, Lavie, Moran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116042/
https://www.ncbi.nlm.nih.gov/pubmed/35597408
http://dx.doi.org/10.1016/j.niox.2022.05.002
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author Lior, Yotam
Yatzkan, Noga
Brami, Ido
Yogev, Yuval
Riff, Reut
Hekselman, Idan
Fremder, Moran
Freixo-Lima, Gabriella
Be'er, Moria
Amirav, Israel
Lavie, Moran
author_facet Lior, Yotam
Yatzkan, Noga
Brami, Ido
Yogev, Yuval
Riff, Reut
Hekselman, Idan
Fremder, Moran
Freixo-Lima, Gabriella
Be'er, Moria
Amirav, Israel
Lavie, Moran
author_sort Lior, Yotam
collection PubMed
description OBJECTIVE: To assess the feasibility of Fractional exhaled Nitric Oxide (FeNO) as a simple, non-invasive, cost-effective and portable biomarker and decision support tool for risk stratification of COVID-19 patients. METHODS: We conducted a single-center prospective cohort study of COVID-19 patients whose FeNO levels were measured upon ward admission by the Vivatmo-me handheld device. Demographics, COVID-19 symptoms, and relevant hospitalization details were retrieved from the hospital databases. The patients were divided into those discharged to recover at home and those who died during hospitalization or required admission to an intensive care unit, internal medicine ward, or dedicated facility (severe outcomes group). RESULTS: Fifty-six patients were enrolled. The only significant demographic difference between the severe outcomes patients (n = 14) and the home discharge patients (n = 42) was age (64.21 ± 13.97 vs. 53.98 ± 15.57 years, respectively, P = .04). The admission FeNO measurement was significantly lower in the former group compared with the latter group (15.86 ± 14.74 vs. 25.77 ± 13.79, parts per billion [PPB], respectively, P = .008). Time to severe outcome among patients with FeNO measurements ≤11.8 PPB was significantly shorter compared with patients whose FeNO measured >11.8 PPB (19.25 ± 2.96 vs. 24.41 ± 1.09 days, respectively, 95% confidence interval [CI] 1.06 to 4.25). An admission FeNO ≤11.8 PPB was a significant risk factor for severe outcomes (odds ratio = 12.8, 95% CI: 2.78 to 58.88, P = .001), with a receiver operating characteristics curve of 0.752. CONCLUSIONS: FeNO measurements by the Vivatmo-me handheld device can serve as a biomarker and COVID-19 support tool for medical teams. These easy-to-use, portable, and noninvasive devices may serve as valuable ED bedside tools during a pandemic.
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spelling pubmed-91160422022-05-18 Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity Lior, Yotam Yatzkan, Noga Brami, Ido Yogev, Yuval Riff, Reut Hekselman, Idan Fremder, Moran Freixo-Lima, Gabriella Be'er, Moria Amirav, Israel Lavie, Moran Nitric Oxide Article OBJECTIVE: To assess the feasibility of Fractional exhaled Nitric Oxide (FeNO) as a simple, non-invasive, cost-effective and portable biomarker and decision support tool for risk stratification of COVID-19 patients. METHODS: We conducted a single-center prospective cohort study of COVID-19 patients whose FeNO levels were measured upon ward admission by the Vivatmo-me handheld device. Demographics, COVID-19 symptoms, and relevant hospitalization details were retrieved from the hospital databases. The patients were divided into those discharged to recover at home and those who died during hospitalization or required admission to an intensive care unit, internal medicine ward, or dedicated facility (severe outcomes group). RESULTS: Fifty-six patients were enrolled. The only significant demographic difference between the severe outcomes patients (n = 14) and the home discharge patients (n = 42) was age (64.21 ± 13.97 vs. 53.98 ± 15.57 years, respectively, P = .04). The admission FeNO measurement was significantly lower in the former group compared with the latter group (15.86 ± 14.74 vs. 25.77 ± 13.79, parts per billion [PPB], respectively, P = .008). Time to severe outcome among patients with FeNO measurements ≤11.8 PPB was significantly shorter compared with patients whose FeNO measured >11.8 PPB (19.25 ± 2.96 vs. 24.41 ± 1.09 days, respectively, 95% confidence interval [CI] 1.06 to 4.25). An admission FeNO ≤11.8 PPB was a significant risk factor for severe outcomes (odds ratio = 12.8, 95% CI: 2.78 to 58.88, P = .001), with a receiver operating characteristics curve of 0.752. CONCLUSIONS: FeNO measurements by the Vivatmo-me handheld device can serve as a biomarker and COVID-19 support tool for medical teams. These easy-to-use, portable, and noninvasive devices may serve as valuable ED bedside tools during a pandemic. Elsevier Inc. 2022-07-01 2022-05-18 /pmc/articles/PMC9116042/ /pubmed/35597408 http://dx.doi.org/10.1016/j.niox.2022.05.002 Text en © 2022 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Lior, Yotam
Yatzkan, Noga
Brami, Ido
Yogev, Yuval
Riff, Reut
Hekselman, Idan
Fremder, Moran
Freixo-Lima, Gabriella
Be'er, Moria
Amirav, Israel
Lavie, Moran
Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title_full Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title_fullStr Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title_full_unstemmed Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title_short Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity
title_sort fractional exhaled nitric oxide (feno) level as a predictor of covid-19 disease severity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116042/
https://www.ncbi.nlm.nih.gov/pubmed/35597408
http://dx.doi.org/10.1016/j.niox.2022.05.002
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