Base de datos UCIR.xlsx

BACKGROUND: 15% of COVID-19 patients develop severe pneumonia. Non-invasivemechanical ventilation and high-flow nasal cannula can reduce the rate ofendotracheal intubation in adult respiratory distress syndrome, although failure rate ishigh. OBJECTIVE: To describe the rate of endotracheal intubation, the effectiveness oftreatment, complications and mortality in patients with severe respiratory failure due toCOVID-19. METHODS: Prospective cohort study in a first-level hospital in Madrid.Patients with a positive polymerase chain reaction for SARS-CoV-2 and admitted to theIntermediate Respiratory Care Unit with tachypnea, use of accessory musculature orSpO2 <92% despite FiO2> 0.5 were included. Intubation rate, medical complications,and 28-day mortality were recorded. Statistical analysis through association studies,logistic and Cox regression models and survival analysis was performed. RESULTS:Seventy patients were included. 37.1% required endotracheal intubation, 58.6%suffered medical complications and 24.3% died. Prone positioning was independentlyassociated with lower need for endotracheal intubation (OR 0.05; 95% CI 0.005 to0.54, p=0.001). The adjusted HR for death at 28 days in the group of patients requiringendotracheal intubation was 5.4 (95% CI 1.51 to 19.5; p=0.009). CONCLUSIONS: Therate of endotracheal intubation in patients with severe respiratory failure from COVID-19 was 37.1%. Complications and mortality were lower in patients in whomendotracheal intubation could be avoided. Prone positioning could reduce the need forendotracheal intubation.