Subject(s)
COVID-19/prevention & control , Continuous Positive Airway Pressure/statistics & numerical data , Patient Compliance/statistics & numerical data , Sleep Apnea, Obstructive/therapy , Adult , Aged , Female , France , Health Policy , Humans , Linear Models , Longitudinal Studies , Male , Middle AgedSubject(s)
COVID-19/epidemiology , Continuous Positive Airway Pressure/statistics & numerical data , Pandemics , Patient Compliance/statistics & numerical data , SARS-CoV-2 , Sleep Apnea, Obstructive/therapy , Aged , COVID-19/psychology , Female , Humans , Male , Middle Aged , Quarantine/statistics & numerical data , Severity of Illness Index , Sex Factors , Spain/epidemiology , Statistics, Nonparametric , Telemetry/statistics & numerical data , Time FactorsSubject(s)
COVID-19/complications , High-Frequency Ventilation/statistics & numerical data , Noninvasive Ventilation/statistics & numerical data , Respiratory Insufficiency/therapy , Aged , COVID-19/mortality , Continuous Positive Airway Pressure/statistics & numerical data , High-Frequency Ventilation/mortality , Humans , Middle Aged , Noninvasive Ventilation/mortality , Oxygen Inhalation Therapy/statistics & numerical data , Prone Position , Registries , Respiratory Insufficiency/etiology , Respiratory Insufficiency/mortality , Spain/epidemiologyABSTRACT
BACKGROUND: Gender-related factors might affect vulnerability to Covid-19. The aim of this study was to describe the role of gender on clinical features and 28-day mortality in Covid-19 patients. METHODS: Observational study of Covid-19 patients hospitalized in Bergamo, Italy, during the first three weeks of the outbreak. Medical records, clinical, radiological and laboratory findings upon admission and treatment have been collected. Primary outcome was 28-day mortality since hospitalization. RESULTS: 431 consecutive adult patients were admitted. Female patients were 119 (27.6%) with a mean age of 67.0 ± 14.5 years (vs 67.8 ± 12.5 for males, p = 0.54). Previous history of myocardial infarction, vasculopathy and former smoking habits were more common for males. At the time of admission PaO2/FiO2 was similar between men and women (228 [IQR, 134-273] vs 238 mmHg [150-281], p = 0.28). Continuous Positive Airway Pressure (CPAP) assistance was needed in the first 24 h more frequently in male patients (25.7% vs 13.0%; p = 0.006). Overall 28-day mortality was 26.1% in women and 38.1% in men (p = 0.018). Gender did not result an independent predictor of death once the parameters related to disease severity at presentation were included in the multivariable analysis (p = 0.898). Accordingly, the Kaplan-Meier survival analysis in female and male patients requiring CPAP or non-invasive ventilation in the first 24 h did not find a significant difference (p = 0.687). CONCLUSION: Hospitalized women are less likely to die from Covid-19; however, once severe disease occurs, the risk of dying is similar to men. Further studies are needed to better investigate the role of gender in clinical course and outcome of Covid-19.
Subject(s)
COVID-19/epidemiology , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/physiopathology , COVID-19/therapy , Comorbidity , Continuous Positive Airway Pressure/statistics & numerical data , Diabetes Mellitus/epidemiology , Female , Humans , Hypertension/epidemiology , Hypoxia/epidemiology , Hypoxia/physiopathology , Hypoxia/therapy , Italy/epidemiology , Kaplan-Meier Estimate , Male , Middle Aged , Myocardial Infarction/epidemiology , Noninvasive Ventilation/statistics & numerical data , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Smoking/epidemiologyABSTRACT
None: A middle-aged man with obstructive sleep apnea who had been treated with continuous positive airway pressure developed COVID-19. An analysis of airflow records from the continuous positive airway pressure machine revealed a rise in his respiratory rate on the night before the onset of COVID-19-related symptoms, while his nocturnal respiratory rate had been stable during the 18-month period prior to the presently reported episode. The present case suggests that a rise in respiratory rate detected using continuous positive airway pressure machine data could be an important sign of impending acute illness, such as COVID-19. Studies to elucidate the usefulness of this method are warranted.
Subject(s)
Betacoronavirus , Continuous Positive Airway Pressure/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Respiratory Rate/physiology , Sleep Apnea, Obstructive/therapy , COVID-19 , Humans , Male , Middle Aged , Pandemics , Polysomnography/methods , SARS-CoV-2ABSTRACT
The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees. The abnormally high influx of patients, together with the limited resources available, has forced clinicians to make unprecedented decisions and provide compassionate treatments for which little or no evidence is yet available. This is the case for the use of noninvasive positive pressure ventilation and continuous airway pressure ventilation, combined with prone position in patients with COVID-19 and acute respiratory distress syndrome treated outside of intensive care units. In our article, we comment on the evidence available, so far, and provide a brief summary of data collected at our health institution in Piedmont, Italy.