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