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This observational cohort study will enroll patients in LMICs with suspected or confirmed COVID-19 on oxygen or deemed to require oxygen therapy based on objective criteria. Demographics and risk factor information will be collected from participants. Participants will be followed for 7 days or until outcome (hospital discharge or death). Facility level metrics on oxygen availability will also be collected at the beginning of site enrolment.
The COVID-19 pandemic has highlighted, more than ever, the acute need for scale up of oxygen therapy. WHO has provided an inventory tool to quantify facility-level provision of infrastructure to deliver oxygen therapy. However, data on the use of oxygen therapy at the patient-level remains lacking. This observational cohort study will enroll patients in LMICs with suspected or confirmed COVID-19 on oxygen or deemed to require oxygen therapy based on objective criteria. Demographics and risk factor information will be collected from participants. Participants will be followed for 7 days or until outcome (hospital discharge or death). Facility level metrics on oxygen availability will also be collected at the beginning of site enrolment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients 12 years of age or older with suspected or confirmed COVID-19, deemed to require oxygen. |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients receiving oxygen via each of various delivery devices. | Oxygen delivery devices analysed: nasal cannulae, face mask, Venturi, NRB, HFNO, CPAP, NIV, IMV | Over first 7 days of hospitalization |
| Proportion of patients progressing to invasive mechanical ventilation | If available at facility | Over first 7 days of hospitalization |
| Total oxygen requirements in patients receiving oxygen via each of various delivery devices. | Daily oxygen use measured in liters. For nasal cannula, facemask, and non-rebreather FiO2 is assumed to be 1.0 and flow rates are adjustable in liters per minute. Liter per day consumption of O2 = device flow rate L/minute x 60 minutes/hr x 24 hr/day For high flow nasal cannula FiO2 is adjustable (defaulted to 1.0) and flow rate is adjustable in liters per minute. Liter per day consumption of O2 = device flow rate L/minute x 60 minutes/hr x 24 hr/day; flow rate in LPM = device flow rate x (FiO2 - 0.21)/0.79 For ventilator, CPAP, BIPAP/NIPPV FiO2 is adjustable (defaulted to 1.0) and flow rate is adjustable in liters per minute and dependent on multiple factors. Liter per day consumption of O2 = device O2 consumption rate L/minute x 60 minutes/hr x 24 hr/day Device O2 consumption rate in LPM = (Minute ventilation + (bias flow x RR x expiratory time/60) + leak) x (FiO2 - 0.21)/0.79 | Over first 7 days of hospitalization |
| Measure | Description | Time Frame |
|---|---|---|
| Demographics and outcomes at hospital discharge of cohort of hospitalized patients | Baseline characteristics, daily parameters over 7 days, hospital outcomes | Until patient discharge from hospital or death, censored at 30 days. |
| Quantification of total oxygen supply at each facility |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who access emergency unit/department (if available) or anywhere acutely ill patients are first assessed.
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| Name | Affiliation | Role |
|---|---|---|
| WHO | World Health Organization | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| World Health Organization | Geneva | Other | 1202 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41519152 | Derived | Relan P, Rylance J, Arabi YM, Convocar P, Rolland M, Diaz JV; O2CoV2 investigators. Medical oxygen and respiratory support requirements for patients hospitalised with COVID-19 in 23 low-income and middle-income countries: a prospective, observational cohort study. Lancet Glob Health. 2026 Feb;14(2):e233-e241. doi: 10.1016/S2214-109X(25)00480-2. | |
| 37591648 |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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Description of oxygen source, distribution and biomedical equipment at facility level and estimated oxygen capacity at the facility level |
| One time at beginning of enrolment |
| Relan P, Murthy S, Marshall JC, Annane D, Chevret S, Arabi YM, Waweru-Siika W, Dominguez Rodriguez S, Convocar P, Diaz J; World Health Organization Respiratory Support Research Group; World Health Organization O2CoV2 International Study Steering Committee. WHO O2CoV2: oxygen requirements and respiratory support in patients with COVID-19 in low-and-middle income countries-protocol for a multicountry, prospective, observational cohort study. BMJ Open. 2023 Aug 17;13(8):e071346. doi: 10.1136/bmjopen-2022-071346. |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |