Does the intubation timeline affect the in-hospital mortality of COVID-19 patients? A retrospective cohort study

Abstract

BackgroundEffective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality.MethodsBetween January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information.ResultsFifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; p < 0.000) along with more underlying comorbidities (3.0; p < 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%).ConclusionIn summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.

Outcomes of patients aged ≥80 years with respiratory failure initially treated with non-invasive ventilation in European intensive care units before and during COVID-19 pandemic

“…This may be a least partially related to longer exposure to NIV which is associated with patient self-inflicted lung injury potentially leading to worse outcomes [ 7 , 28 ]. On the other hand, our analyses showed that the 30-day mortality of patients who required invasive mechanical ventilation was similar regardless of previous NIV attempt in both cohorts while some previous studies showed that early intubation may even be associated with worse outcomes [ 29 ]. The optimal timing of intubation remains unclear and requires further research.…”

COVID-19 vaccine reluctance and possible driving factors: A comparative assessment among pregnant and non-pregnant women

“…Thousands of casualties have occurred as a result of the coronavirus disease pandemic of 2019 (COVID-19), which has also triggered public health challenges, overwhelmed healthcare infrastructures, disrupted supply chains, and the economic systems, and ended up causing a mental illness epidemic ( 1 – 3 ). Epidemiological evidence demonstrated that expectant women have a higher tendency for contracting COVID-19 infection ( 4 , 5 ). The rate of hospitalization in intensive care departments and the need for mechanical respiration have been reported far higher in pregnant women than in non-pregnant women.…”

Psychological dynamics of pandemic resilience: a tale of two cultures

“…Communication with other individuals was limited due to the compulsory utilisation of facial masks and adherence to various protective measures implemented to mitigate the spread of the virus, which encompassed limitations on moving outside living quarters, self-isolation mandates, and the practice of maintaining a certain physical distance. Social contact regulations were implemented by all nations to regulate social interactions, resulting in a restriction of varying magnitudes that hindered the inherent ease and impromptu nature of interpersonal connections (Rehman et al, 2022 Shah et al, 2022 ).…”

“…These measures, resembling the global response to the pandemic, have had significant ramifications on the lives of the population at large (Mukhtar, 2020 ). The epidemic has exerted profound impacts on the social and psychological well-being of numerous individuals (Rana et al, 2020 ; Rehman et al, 2022 ). The presence of the virus within an individual or one's family unit, coupled with concerns for the well-being of cherished relatives, the economic repercussions stemming from the halt in activities, and the challenges in obtaining medical assistance have collectively exerted a detrimental influence on individuals (Subba et al, 2020 ).…”