Survival analysis of COVID-19 patients treated with different modes of respiratory support in the ICU

ABSTRACT

Introduction: This study is the first to focus on the different respiratory support modes and outcomes of critically ill patients with COVID- 19 in Wuhan. The cohort study design is persuasive. The number of studies retrieved is limited in patients with MDRO coinfected with COVID-19. This study only selected critically ill patients with COVID-19 in Leishenshan Hospital. Objectives: We aimed to describe the clinical characteristics and outcomes of five different modes of respiratory support among critically ill patients with coronavirus disease 2019 (COVID-19). Methods: This was a hospital-based, retrospective cohort study which setting on Leishenshan hospital in Wuhan, central China. Patients with COVID-19 admitted to the ICU of Leishenshan Hospital from February 8, 2020 to April 18, 2020 were recruited. The outcome was living status and survival time. Results: Thirty-five patients died among 114 hospitalization patients (mortality rate, 30.7%), and 56 patients (49.12%) used mechanical ventilation. The mean survival time (days) of patients without respiratory support, noninvasive positive-pressure ventilation (NIPPV), endotracheal intubation, tracheotomy, or endotracheal intubation before and after tracheotomy (EI + T) was 15, 34, 32, 12.5, and 6, respectively (p < 0.000). Eighteen (15.79%) patients were co-infected with MDROs, primarily in the EI + T group (83.33%). The mortality risk of patients treated with NIPPV and EI + T was 0.20 and 0.21 times higher than that of patients without any respiratory support (95% confidence interval [CI] = 0.002-0.203;95% CI = 0.002-0.218). The mode of respiratory support was an independent factor affecting the survival of ICU patients with COVID-19. Conclusion: Mortality risk in patients with NIPPV and EI + T was lower than in those without any respiratory support. Timely and correct respiratory support mode is the key to reducing the death of critically ill patients with COVID-19.