TY - JOUR T1 - Outcomes of COVID-19 patients treated with continuous positive airway pressure outside the intensive care unit JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00541-2020 VL - 7 IS - 1 SP - 00541-2020 AU - Rosanna Vaschetto AU - Francesco Barone-Adesi AU - Fabrizio Racca AU - Claudio Pissaia AU - Carlo Maestrone AU - Davide Colombo AU - Carlo Olivieri AU - Nello De Vita AU - Erminio Santangelo AU - Lorenza Scotti AU - Luigi Castello AU - Tiziana Cena AU - Martina Taverna AU - Luca Grillenzoni AU - Maria Adele Moschella AU - Gianluca Airoldi AU - Silvio Borrè AU - Francesco Mojoli AU - Francesco Della Corte AU - Marta Baggiani AU - Sara Baino AU - Piero Balbo AU - Simona Bazzano AU - Valeria Bonato AU - Sara Carbonati AU - Federico Crimaldi AU - Veronica Daffara AU - Luca De Col AU - Matteo Maestrone AU - Mario Malerba AU - Federica Moroni AU - Raffaella Perucca AU - Mario Pirisi AU - Valentina Rondi AU - Daniela Rosalba AU - Letizia Vanni AU - Francesca Vigone AU - Paolo Navalesi AU - Gianmaria Cammarota Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/7/1/00541-2020.abstract N2 - 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 ER -