ABSTRACT
Background: COVID-19 patients who develop hypoxemic respiratory failure despite conventional oxygen therapy usually require high flow nasal oxygen (HFNO) or non-invasive ventilation (NIV). Aim: To compare the effect of both in managing COVID- 19 induced respiratory failure and to determine whether HFNO decreases the rate of intubation when compared with NIV. Settings and design: Single centre, retrospective observational study. Materials and methods: Data collected from medical records. As per the inclusion criteria, patients who received either HFNO or NIV as initial therapy for at least 2 calendar days were analysed. Both the therapies were compared in around 200 patients (HFNO = 100, NIV = 100), with the rate of intubation at day 14 as the primary outcome and length of ICU stay, hospital stay, mortality at day 28, no. of ventilatory free days, complications during ICU stay and comfort score as secondary outcomes. Statistical analysis: Data analysis was done using SPSS software. p value < 0.05 was considered statistically significant. Results: The rate of intubation and mortality rates were higher in the NIV group (P = 0.001), whereas there was no difference in length of hospital or ICU stay among the both (P = 0.15, 0.75, respectively). HFNO group patients were more comfortable (P < 0.05). Conclusion: HFNO is effective in the management of COVID- 19 induced acute hypoxemic respiratory failure with a lower rate of intubation, lower mortality rate, and better tolerance compared to NIV though it does not reduce the duration of ICU or hospital stay.
ABSTRACT
Covid-19 disease outspread and its subsequent control and inhibition strategies in various countries have been different which led to quite drastic differences in the outcome of the disease progression. In this study, we present a simple analytical and numerical study of Covid-19 disease spread and control by applying the modified SIR model of epidemic outbreak to explain the Covid spread from February-July 2020 in various countries. Two approaches are evident from the disease progression: one focused on disease eradication and inhibition and the other is less restrictive dynamic response. Both the approaches are analytically modeled to determine the parameters that characterize the effectiveness of dealing with the disease spread. The model successfully explains the Covid-19 evolution and control of various countries over a vast span of four-five months. The study is highly beneficial to simply analytically and numerically model this complex problem of epidemic proliferation and physical problems involving growth and decay. It assists to easily determine the mathematical parameters for the Covid-19 control measures, helps in predicting the end of the epidemic and most importantly conceiving the judicious way of unlock process to restore communication between cities, states and countries. © 2021, World Research Association. All rights reserved.