Usefulness of the early combination of non-invasive respiratory therapies in patients with COVID-19

ABSTRACT

Aim: To determine the effect of the early combination of high flow nasal cannula (HFNC) plus continuous positive airway pressure (CPAP) regarding endotracheal intubation (ETI) and 30-day mortality in patients with SARS-CoV-2 pneumonia. Method(s) Observational study of patients admitted to the intermediate respiratory care unit (IRCU) who received HFNC+CPAP. Two groups were formed according to the time of starting the combined therapy Early HFNC+CPAP (first 24 h - EHC) and Late HFNC+CPAP (after 24 h - LHC). A multivariate analysis was performed to establish the strength of the association with ETI and 30-day mortality. Result(s) 780 patients were included (502 male, mean age 56.5 +/- 12.9 years). Table 1 shows the baseline characteristics. 273 patients were subjected to ETI, 32.9% in the EHC group vs 38.9% in the LHC group (p 0.05). 30day mortality was 8.2% in the EHC vs 15.5% LHC (p 0.02). Table 2 shows the multivariate analysis. Conclusion(s) The combination of HFNC+CPAP, especially in the first 24 hours after IRCU admission, is a useful tool in the management of SARS-CoV-2 pneumonia.