PMID- 36589198
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 11
DP  - 2022 Nov
TI  - Clinical Outcomes of COVID-19-Induced Acute Respiratory Distress Syndrome in 
      Patients With Three Different Respiratory Support Modalities: A Retrospective 
      Cohort Study.
PG  - e31991
LID - 10.7759/cureus.31991 [doi]
LID - e31991
AB  - Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced 
      acute respiratory failure and acute respiratory distress syndrome (ARDS) had a 
      considerable impact on intensive care utilization and resource optimization. 
      Multiple modalities for respiratory support were implemented during the COVID-19 
      pandemic with the main concern of being able to identify those patients at high 
      risk of rapidly progressive respiratory failure, whom the early initiation of 
      invasive respiratory support would, in particular, affect the outcome in 
      comparison to the noninvasive management strategy. Objectives In our cohort 
      study, we describe demographic characteristics, respiratory support modalities, 
      and their relation to patient outcomes. Method Patients 18 years of age and older 
      who were admitted to a tertiary center COVID-19-dedicated medical intensive care 
      unit (MICU) in Qatar between March 2020 and May 2020 with a confirmed diagnosis 
      of COVID-19 pneumonia were included in this study. Patients were divided into 
      invasive or noninvasive, and those who required invasive strategy were subdivided 
      into the early intubation group (patients who were intubated within 72 hours of 
      intensive care unit (ICU) admission) and the late intubation group (patients who 
      were intubated after 72 hours from ICU admission). The primary outcome was ICU 
      and hospital mortality, and the secondary effects were the length of stay and 
      mortality determinants. Results A total of 686 patients were admitted to the 
      medical intensive care unit (MICU) during the study period. There were 222 
      (32.4%), 131 (19.1%), and 333 (48.5%) patients in the early, late, and not 
      intubated groups, respectively. Compared to the late intubated group, the early 
      intubated group had a higher proportion of males. Diabetes (39.8%) was the most 
      common comorbidity, followed by hypertension (HTN) (36%) and heart disease 
      (9.8%). The 30-day ICU and hospital mortality were significantly higher in the 
      late intubated group compared to the early intubated group (30.5% versus 15.8%, 
      and 30% versus 16.2%). The median ICU and hospital stay days in the total sample 
      were 8 (interquartile range (IQR): 5-14) and 19 (IQR: 14-25), respectively. The 
      mean estimates of 30-day ICU survival times for early intubated, late intubated, 
      and not intubated groups were 25.14 (95% confidence interval (CI): 23.71, 26.57), 
      23.35 (95% CI: 21.63, 25.07), and 29.91 (95% CI: 29.74, 30.09) respectively. 
      Conclusions In our study, the COVID-19 ARDS patients who required early invasive 
      ventilatory support and in whom the physiological parameter was more severe 
      (Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential 
      Organ Failure Assessment (SOFA) scores) had a better outcome than the late 
      intubation group. Age more than 60 years old, diabetes, hypertension, chronic 
      kidney disease (CKD), and chronic liver disease (CLD) were the main predictor of 
      mortality in total.
CI  - Copyright (c) 2022, Alamami et al.
FAU - Alamami, Ans
AU  - Alamami A
AD  - Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.
FAU - Imaduddeen, Tahir
AU  - Imaduddeen T
AD  - Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, CAN.
FAU - Ibrahim, Ezzedi A
AU  - Ibrahim EA
AD  - Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.
FAU - Ibrahim, Abdusalam S
AU  - Ibrahim AS
AD  - Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.
FAU - Raza, Tasleem
AU  - Raza T
AD  - Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.
LA  - eng
PT  - Journal Article
DEP - 20221128
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9797753
OTO - NOTNLM
OT  - ards
OT  - covid-19
OT  - niv
OT  - p-sili
OT  - sars-cov-2
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/01/03 06:00
MHDA- 2023/01/03 06:01
PMCR- 2022/11/28
CRDT- 2023/01/02 03:52
PHST- 2022/11/28 00:00 [accepted]
PHST- 2023/01/02 03:52 [entrez]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/01/03 06:01 [medline]
PHST- 2022/11/28 00:00 [pmc-release]
AID - 10.7759/cureus.31991 [doi]
PST - epublish
SO  - Cureus. 2022 Nov 28;14(11):e31991. doi: 10.7759/cureus.31991. eCollection 2022 
      Nov.