In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 12 ( 2020-12-16), p. e0243968-
Abstract:
15% of COVID-19 patients develop severe pneumonia. Non-invasive mechanical ventilation and high-flow nasal cannula can reduce the rate of endotracheal intubation in adult respiratory distress syndrome, although failure rate is high. Objective To describe the rate of endotracheal intubation, the effectiveness of treatment, complications and mortality in patients with severe respiratory failure due to COVID-19. Methods Prospective cohort study in a first-level hospital in Madrid. Patients with a positive polymerase chain reaction for SARS-CoV-2 and admitted to the Intermediate Respiratory Care Unit with tachypnea, use of accessory musculature or Sp O2 〈 92% despite Fi O2 〉 0.5 were included. Intubation rate, medical complications, and 28-day mortality were recorded. Statistical analysis through association studies, logistic and Cox regression models and survival analysis was performed. Results Seventy patients were included. 37.1% required endotracheal intubation, 58.6% suffered medical complications and 24.3% died. Prone positioning was independently associated with lower need for endotracheal intubation (OR 0.05; 95% CI 0.005 to 0.54, p = 0.001). The adjusted HR for death at 28 days in the group of patients requiring endotracheal intubation was 5.4 (95% CI 1.51 to 19.5; p = 0.009). Conclusions The rate of endotracheal intubation in patients with severe respiratory failure from COVID-19 was 37.1%. Complications and mortality were lower in patients in whom endotracheal intubation could be avoided. Prone positioning could reduce the need for endotracheal intubation.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0243968
DOI:
10.1371/journal.pone.0243968.g001
DOI:
10.1371/journal.pone.0243968.g002
DOI:
10.1371/journal.pone.0243968.g003
DOI:
10.1371/journal.pone.0243968.t001
DOI:
10.1371/journal.pone.0243968.t002
DOI:
10.1371/journal.pone.0243968.t003
DOI:
10.1371/journal.pone.0243968.s001
DOI:
10.1371/journal.pone.0243968.s002
DOI:
10.1371/journal.pone.0243968.s003
DOI:
10.1371/journal.pone.0243968.s004
DOI:
10.1371/journal.pone.0243968.s005
DOI:
10.1371/journal.pone.0243968.r001
DOI:
10.1371/journal.pone.0243968.r002
DOI:
10.1371/journal.pone.0243968.r003
DOI:
10.1371/journal.pone.0243968.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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