Question: Timing of intubation in COVID-19 is controversial. We sought to determine the association of ROX index defined as: oxygen saturation, divided by fraction of inspired oxygen, divided by breathing frequency at time of intubation with clinical outcomes.
Findings: Of 1,087 subjects in the analysis group, the median age was 64 years, and more than half had diabetes; 55.2% died, 1.8% were discharged to hospice, 7.8% were discharged home, 27.3% were discharged to another institution and 7.8% had another disposition. Increasing age and longer time from admission to intubation were associated with mortality. After adjusting for sex, race, age, comorbidities, and days from admission to intubation, increasing ROX score at time of intubation was associated with lower risk of death.
Meaning: Among a cohort of COVID-19 subjects who were ultimately intubated, higher ROX at time of intubation was positively associated with survival.
