Abstract
Purpose: To determine whether time-to-intubation was associated with higher ICU mortality in patients with COVID-19 on mechanical ventilation due to respiratory insufficiency.
Materials and methods: We conducted an observational, prospective, single-center study of patients with confirmed SARS-CoV-2 infection hospitalized with moderate to severe ARDS, connected to mechanical ventilation in the ICU between March 17 and July 31, 2020. We examined their general and clinical characteristics. Time-to-intubation was the time from hospital admission to endotracheal intubation.
Results: We included 183 consecutive patients; 28% were female, and median age was 62 years old. Eighty-eight patients (48%) were intubated before 48 h (early) and ninety-five (52%) after 48 h (late). Patients intubated early had similar admission PaO 2 /FiO 2 ratio (123 vs 99; p = 0.179) but were younger (59 vs 64; p = 0.013) and had higher body mass index (30 vs 28; p = 0.006) compared to patients intubated late. Mortality was higher in patients intubated late (18% versus 43%), with admission PaO 2 /FiO 2 ratio < 100 mmHg (OR 5.2; p = 0.011), of older age (OR 1.1; p = 0.001), and with previous use of ACE inhibitors (OR 4.8; p = 0.026).
Conclusions: In COVID-19 patients, late intubation, Pafi <100, older age, and previous ACE inhibitors use were associated with increased ICU mortality.
Keywords: ARDS; COVID-19; Mechanical ventilation; SARS-CoV-2.
【저자키워드】 COVID-19, ARDS, mechanical ventilation, SARS-CoV-2., 【초록키워드】 SARS-CoV-2, Hospitalized, Mortality, Clinical characteristics, SARS-COV-2 infection, intubation, ICU, body mass index, female, Patient, Older age, ACE inhibitor, Hospital admission, Admission, moderate, COVID-19 patients, Endotracheal intubation, Intubated, median age, severe ARDS, single-center study, material, examined, conducted, determine, Mechanical, on mechanical ventilation, PaO, patients with COVID-19, 【제목키워드】 SARS-COV-2 infection, outcome, Patient, acute respiratory distress, syndrome,