PT  - JOURNAL ARTICLE
AU  - Vaschetto, Rosanna
AU  - Barone-Adesi, Francesco
AU  - Racca, Fabrizio
AU  - Pissaia, Claudio
AU  - Maestrone, Carlo
AU  - Colombo, Davide
AU  - Olivieri, Carlo
AU  - De Vita, Nello
AU  - Santangelo, Erminio
AU  - Scotti, Lorenza
AU  - Castello, Luigi
AU  - Cena, Tiziana
AU  - Taverna, Martina
AU  - Grillenzoni, Luca
AU  - Moschella, Maria Adele
AU  - Airoldi, Gianluca
AU  - Borrè, Silvio
AU  - Mojoli, Francesco
AU  - Della Corte, Francesco
AU  - Baggiani, Marta
AU  - Baino, Sara
AU  - Balbo, Piero
AU  - Bazzano, Simona
AU  - Bonato, Valeria
AU  - Carbonati, Sara
AU  - Crimaldi, Federico
AU  - Daffara, Veronica
AU  - De Col, Luca
AU  - Maestrone, Matteo
AU  - Malerba, Mario
AU  - Moroni, Federica
AU  - Perucca, Raffaella
AU  - Pirisi, Mario
AU  - Rondi, Valentina
AU  - Rosalba, Daniela
AU  - Vanni, Letizia
AU  - Vigone, Francesca
AU  - Navalesi, Paolo
AU  - Cammarota, Gianmaria
TI  - Outcomes of COVID-19 patients treated with continuous positive airway pressure outside the intensive care unit
AID  - 10.1183/23120541.00541-2020
DP  - 2021 Jan 01
TA  - ERJ Open Research
PG  - 00541-2020
VI  - 7
IP  - 1
4099  - http://openres.ersjournals.com/content/7/1/00541-2020.short
4100  - http://openres.ersjournals.com/content/7/1/00541-2020.full
SO  - erjor2021 Jan 01; 7
AB  - Aim We aimed to characterise a large population of coronavirus disease 2019 (COVID-19) patients with moderate-to-severe hypoxaemic acute respiratory failure (ARF) receiving continuous positive airway pressure (CPAP) outside the intensive care unit (ICU), and to ascertain whether the duration of CPAP application increased the risk of mortality for patients requiring intubation.Methods In this retrospective, multicentre cohort study, we included adult COVID-19 patients, treated with CPAP outside ICU for hypoxaemic ARF from 1 March to 15 April, 2020. We collected demographic and clinical data, including CPAP therapeutic goal, hospital length of stay and 60-day in-hospital mortality.Results The study included 537 patients with a median (interquartile range (IQR) age of 69 (60–76) years. 391 (73%) were male. According to the pre-defined CPAP therapeutic goal, 397 (74%) patients were included in the full treatment subgroup, and 140 (26%) in the do not intubate (DNI) subgroup. Median (IQR) CPAP duration was 4 (1–8) days, while hospital length of stay was 16 (9–27) days. 60-day in-hospital mortality was 34% (95% CI 0.304–0.384%) overall, and 21% (95% CI 0.169–0.249%) and 73% (95% CI 0.648–0.787%) for full treatment and DNI subgroups, respectively. In the full treatment subgroup, in-hospital mortality was 42% (95% CI 0.345–0.488%) for 180 (45%) CPAP failures requiring intubation, and 2% (95% CI 0.008–0.035%) for the remaining 217 (55%) patients who succeeded. Delaying intubation was associated with increased mortality (hazard ratio 1.093, 95% CI 1.010–1.184).Conclusions We described a large population of COVID-19 patients treated with CPAP outside ICU. Intubation delay represents a risk factor for mortality. Further investigation is needed for early identification of CPAP failures.This study describes characteristics and in-hospital mortality of the largest population of COVID-19 patients treated with CPAP outside ICU. Treatment duration for patients failing CPAP prior to intubation represents a risk factor for mortality. https://bit.ly/3orolzd