• This record comes from PubMed

Does the intubation timeline affect the in-hospital mortality of COVID-19 patients? A retrospective cohort study

. 2022 ; 9 () : 1023229. [epub] 20221006

Status PubMed-not-MEDLINE Language English Country Switzerland Media electronic-ecollection

Document type Journal Article

BACKGROUND: Effective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality. METHODS: Between January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information. RESULTS: Fifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; p < 0.000) along with more underlying comorbidities (3.0; p < 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%). CONCLUSION: In summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.

See more in PubMed

Gallè F, Sabella EA, Da Molin G, De Giglio O, Caggiano G, Di Onofrio V, et al. . Understanding knowledge and behaviors related to CoViD−19 epidemic in Italian undergraduate students: the EPICO study. Int J Environ Res Public Health. (2020) 17:3481. 10.3390/ijerph17103481 PubMed DOI PMC

Rehman S, Rehman N, Mumtaz A, Jiang J. Association of mortality-related risk factors in patients with COVID-19: a retrospective cohort study. Healthcare. (2021) 9:1468. 10.3390/healthcare9111468 PubMed DOI PMC

Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of COVID-19 epidemic declaration on psychological consequences: a study on active Weibo users. Int J Environ Res Public Health. (2020) 17:2032. 10.3390/ijerph17062032 PubMed DOI PMC

Liu Z, Magal P, Seydi O, Webb G. Understanding unreported cases in the COVID-19 epidemic outbreak in Wuhan, China, and the importance of major public health interventions. Biology. (2020) 9:50. 10.3390/biology9030050 PubMed DOI PMC

Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. . COVID-19 pneumonia: different respiratory treatments for different phenotypes?. Inten Care Med. (2020) 46:1099–102. 10.1007/s00134-020-06033-2 PubMed DOI PMC

Chaplin S. COVID-19: a brief history and treatments in development. Prescriber. (2020) 31:23–8. 10.1002/psb.1843 DOI

Schmidt M, Langouet E, Hajage D, James SA, Chommeloux J, Bréchot N, et al. . Evolving outcomes of extracorporeal membrane oxygenation support for severe COVID-19 ARDS in Sorbonne hospitals, Paris. Crit Care. (2021) 25:1–1. 10.1186/s13054-021-03780-6 PubMed DOI PMC

Liu S, Peng D, Qiu H, Yang K, Fu Z, Zou L. Mesenchymal stem cells as a potential therapy for COVID-19. Stem Cell Res Ther. (2020) 11:1–4. 10.1186/s13287-020-01678-8 PubMed DOI PMC

Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. . Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. (2020) 323:1574–81. 10.1001/jama.2020.5394 PubMed DOI PMC

Siempos II, Xourgia E, Ntaidou TK, Zervakis D, Magira EE, Kotanidou A, et al. . Effect of early vs. delayed or no intubation on clinical outcomes of patients with COVID-19: an observational study. Front Med. (2020) 7:614152. 10.3389/fmed.2020.614152 PubMed DOI PMC

Papoutsi E, Giannakoulis VG, Xourgia E, Routsi C, Kotanidou A, Siempos II. Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies. Crit Care. (2021) 25:1–9. 10.1186/s13054-021-03540-6 PubMed DOI PMC

Lee YH, Choi KJ, Choi SH, Lee SY, Kim KC, Kim EJ, et al. . Clinical significance of timing of intubation in critically ill patients with COVID-19: a multi-center retrospective study. J Clin Med. (2020) 9:2847. 10.3390/jcm9092847 PubMed DOI PMC

Tsolaki V, Zakynthinos GE. Timing of intubation in COVID-19 ARDS: what “time” really matters?. Crit Care. (2021) 25:1–2. 10.1186/s13054-021-03598-2 PubMed DOI PMC

Lee CP, Yip YY, Chan AK, Ko CP, Joynt GM. Early intubation versus late intubation for COVID-19 patients: an in situ simulation identifying factors affecting performance and infection control in airway management. Anaesth Intens Care. (2021) 49:284–91. 10.1177/0310057X211007862 PubMed DOI

Kaur R, Vines DL, Mirza S, Elshafei A, Jackson JA, Harnois LJ, et al. . Early versus late awake prone positioning in non-intubated patients with COVID-19. Crit Care. (2021) 25:1–9. 10.1186/s13054-021-03761-9 PubMed DOI PMC

Rola P, Farkas J, Spiegel R, Kyle-Sidell C, Weingart S, Duggan L, et al. . Rethinking the early intubation paradigm of COVID-19: time to change gears?. Clin Exp Emerg Med. (2020) 7:78. 10.15441/ceem.20.043 PubMed DOI PMC

Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A, et al. . Consensus guidelines for managing the airway in children with COVID-19. Anaesthesia. (2020) 75:785–99. 10.1111/anae.15054 PubMed DOI PMC

Zuo M, Huang Y, Ma W, Xue Z, Zhang J, Gong Y, et al. . Expert recommendations for tracheal intubation in critically ill patients with noval coronavirus disease 2019. Chinese Med Sci J. (2020) 35:105–9. 10.24920/003724 PubMed DOI PMC

Cruces P, Retamal J, Hurtado DE, Erranz B, Iturrieta P, González C, et al. . A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection. Crit Care. (2020) 24:1–0. 10.1186/s13054-020-03197-7 PubMed DOI PMC

Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA. (2020) 323:2329–30. 10.1001/jama.2020.6825 PubMed DOI

McKay B, Meyers M, Rivard L, Stankewicz H, Stoltzfus JC, Rammohan G. Comparison of early and late intubation in COVID-19 and its effect on mortality. Inter J Environ Res Public Health. (2022) 19:3075. 10.3390/ijerph19053075 PubMed DOI PMC

Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. . Intubation and ventilation amid the COVID-19 outbreak: Wuhan's experience. Anesthesiology. (2020) 132:1317–32. 10.1097/ALN.0000000000003296 PubMed DOI PMC

Behesht Aeen F, Pakzad R, Goudarzi Rad M, Abdi F, Zaheri F, Mirzadeh N. Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis. Sci Rep. (2021) 11:1–6. 10.1038/s41598-021-93739-y PubMed DOI PMC

Diehl JL, Peron N, Chocron R, Debuc B, Guerot E, Hauw-Berlemont C, et al. . Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study. Ann Intens Care. (2020) 10:1–7. 10.1186/s13613-020-00716-1 PubMed DOI PMC

So C, Ro S, Murakami M, Imai R, Jinta T. High-dose, short-term corticosteroids for ARDS caused by COVID-19: a case series. Respirol Case Rep. (2020) 8:e00596. 10.1002/rcr2.596 PubMed DOI PMC

Li X, Ma X. Acute respiratory failure in COVID-19: is it “typical” ARDS?. Critical Care. (2020) 24:1–5. 10.1186/s13054-020-02911-9 PubMed DOI PMC

Lentz S, Roginski MA, Montrief T, Ramzy M, Gottlieb M, Long B. Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS. Am J Emerg Med. (2020) 38:2194–202. 10.1016/j.ajem.2020.06.082 PubMed DOI PMC

Tobin MJ, Laghi F, Jubran A. Caution about early intubation and mechanical ventilation in COVID-19. Ann Intens Care. (2020) 10:1–3. 10.1186/s13613-020-00692-6 PubMed DOI PMC

Matta A, Chaudhary S, Lo KB, DeJoy III R, Gul F, Torres R, et al. . Timing of intubation and its implications on outcomes in critically ill patients with coronavirus disease 2019 infection. Crit Care Explor. (2020) 2:e0262. 10.1097/CCE.0000000000000262 PubMed DOI PMC

Daniel P, Mecklenburg M, Massiah C, Joseph MA, Wilson C, Parmar P, et al. . Non-invasive positive pressure ventilation versus endotracheal intubation in treatment of COVID-19 patients requiring ventilatory support. Am J Emerg Med. (2021) 43:103–8. 10.1016/j.ajem.2021.01.068 PubMed DOI PMC

Tu Y, Yang P, Zhou Y, Wen X, Li Q, Zhou J, et al. . Risk factors for mortality of critically ill patients with COVID-19 receiving invasive ventilation. Int J Med Sci. (2021) 18:1198. 10.7150/ijms.50039 PubMed DOI PMC

Winck JC, Ambrosino N. COVID-19 pandemic and non invasive respiratory management: every Goliath needs a David. An evidence based evaluation of problems. Pulmonology. (2020) 26:213–20. 10.1016/j.pulmoe.2020.04.013 PubMed DOI PMC

Rehman S, Li X, Wang C, Ikram M, Rehman E, Liu M. Quality of care for patients with acute myocardial infarction (AMI) in Pakistan: a retrospective study. Int J Environ Res Public Health. (2019) 16:3890. 10.3390/ijerph16203890 PubMed DOI PMC

Zhang R, Wang X, Ni L, Di X, Ma B, Niu S, et al. . COVID-19: Melatonin as a potential adjuvant treatment. Life Sci. (2020) 250:117583. 10.1016/j.lfs.2020.117583 PubMed DOI PMC

Solun B, Shoenfeld Y. Inhibition of metalloproteinases in therapy for severe lung injury due to COVID-19. Med Drug Discov. (2020) 7:100052. 10.1016/j.medidd.2020.100052 PubMed DOI PMC

Martinez Mesa A, Cabrera César E, Martín-Montañez E, Sanchez Alvarez E, Lopez PM, Romero-Zerbo Y, et al. . Acute lung injury biomarkers in the prediction of COVID-19 severity: total thiol, ferritin and lactate dehydrogenase. Antioxidants. (2021) 10:1221. 10.3390/antiox10081221 PubMed DOI PMC

King CS, Sahjwani D, Brown AW, Feroz S, Cameron P, Osborn E, et al. . Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure. PLoS ONE. (2020) 15:e0242651. 10.1371/journal.pone.0242651 PubMed DOI PMC

Gupta VK, Alkandari BM, Mohammed W, Tobar AM, Abdelmohsen MA. Ventilator associated lung injury in severe COVID-19 pneumonia patients–Case Reports: ventilator associated lung injury in COVID-19. Eur J Radiol Open. (2021) 8:100310. 10.1016/j.ejro.2020.100310 PubMed DOI PMC

Rehman S, Rehman E, Mumtaz A, Jianglin Z. Cardiovascular disease mortality and potential risk factor in China: a multi-dimensional assessment by a grey relational approach. Int J Public Health. (2022) 67:1604599. 10.3389/ijph.2022.1604599 PubMed DOI PMC

Tobin MJ. Pondering the atypicality of ARDS in COVID-19 is a distraction for the bedside doctor. Intens Care Med. (2021) 47:361–2. 10.1007/s00134-020-06340-8 PubMed DOI PMC

Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. . Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intens Care Med. (2020) 46:854–87. 10.1007/s00134-020-06022-5 PubMed DOI PMC

Coppo A, Bellani G, Winterton D, Di Pierro M, Soria A, Faverio P, et al. . Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study. Lancet Respir Med. (2020) 8:765–74. 10.1016/S2213-2600(20)30268-X PubMed DOI PMC

Cheung JC, Ho LT, Cheng JV, Cham EY, Lam KN. Staff safety during emergency airway management for COVID-19 in Hong Kong. Lancet Respir Med. (2020) 8:e19. 10.1016/S2213-2600(20)30084-9 PubMed DOI PMC

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...