• COVID-19
• Critical care
• Mechanical ventilation
• Noninvasive ventilation
• SARS-CoV-2

• Humans
• Noninvasive Ventilation/methods
• COVID-19/complications
• COVID-19/therapy
• Respiratory Distress Syndrome/therapy
• Respiratory Distress Syndrome/virology
• Respiration, Artificial/methods
• SARS-CoV-2
• Oxygen Inhalation Therapy/methods
• Continuous Positive Airway Pressure
• Length of Stay
• Respiratory Insufficiency/therapy
• Respiratory Insufficiency/virology

• ARDS
• SARS-CoV-2
• high flow oxygen therapy
• surfactant
• vibrating-mesh nebulizers

• ARDS
• COVID-19
• Late intubation
• Mechanical ventilation

• acute respiratory distress syndrome
• airway intubation
• covid-19
• high-flow oxygen
• pneumonia

• Acute respiratory distress syndrome
• coronavirus disease 2019
• pneumonia

To assess laryngologic symptomatology following SARS-CoV-2 infection and determine whether symptom severity correlates with disease severity.

Single-institution survey study in participants with documented SARS-CoV-2 infection between March 2020 and February 2021. Data acquired included demographic, infection severity characteristics, comorbidities, and current upper aerodigestive symptoms via validated patient reported outcome measures.  Primary outcomes of interest were scores of symptom severity questionnaires. COVID-19 severity was defined by hospitalization status. Descriptive subgroup analyses were performed to investigate differences in demographics, comorbidities, and symptom severity in hospitalized participants stratified by ICU status. Multivariate logistical regression was used to evaluate significant differences in symptom severity scores by hospitalization status.

Surveys were distributed to 5300 individuals with upper respiratory infections. Ultimately, 470 participants with COVID-19 were included where 352 were hospitalized and 118 were not hospitalized. Those not hospitalized were younger (45.87 vs. 56.28 years), more likely female (74.17 vs. 58.92%), and less likely white (44.17 vs. 52.41%). Severity of dysphonia, dyspnea, cough, and dysphagia was significantly worse in hospitalized patients overall and remained worse at all time points. Cough severity paradoxically worsened in hospitalized respondents over time. Dyspnea scores remained abnormally elevated in respondents even 12 months after resolution of infection.

Results indicate that laryngologic symptoms are expected to be worse in patients hospitalized with COVID-19. Dyspnea and cough symptoms can be expected to persist or even worsen by one-year post infection in those who were hospitalized. Dysphagia and dysphonia symptoms were mild. Non-hospitalized participants tended to have minimal residual symptoms by one year after infection.

• covid-19
• long covid
• dysphagia
• dysphonia
• sars-cov-2

• Humans
• COVID-19
• Prospective Studies
• Pandemics
• Intubation, Intratracheal/adverse effects
• Respiration, Artificial/adverse effects
• Noninvasive Ventilation
• Respiratory Insufficiency/therapy
• Respiratory Insufficiency/etiology
• Intensive Care Units

• Instituto de Salud Carlos III
• European Social Fund

• viral infection
• cardiology

• Humans
• COVID-19/therapy
• Respiratory Distress Syndrome/therapy
• Intubation, Intratracheal
• Hospital Mortality
• Length of Stay

• COVID-19
• Early intubation
• Mechanical ventilation
• Meta-analysis

Effective 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.

Between 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.

Fifty-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%).

In 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.

• COVID-19
• acute respiratory failure
• early intubation
• emergency unit
• late intubation

• COVID-19
• Critical care
• Healthcare disparities
• Pandemic
• Resource allocation
• SARS-CoV-2

• COVID-19
• Critical Care
• Critical Illness/therapy
• Humans
• Pandemics

• COVID-19
• SARS-CoV-2
• high-flow nasal cannula
• noninvasive ventilation
• viruses

• Adult
• COVID-19/therapy
• Cannula
• Humans
• Noninvasive Ventilation
• Oxygen
• Oxygen Inhalation Therapy
• Respiratory Insufficiency/etiology
• Respiratory Insufficiency/therapy

• R01 HL157985 NHLBI NIH HHS
• T32 HL134632 NHLBI NIH HHS
• T32 HL007035 NHLBI NIH HHS
• K24 HL132105 NHLBI NIH HHS
• R01 HL085188 NHLBI NIH HHS
• R01 AG063925 NIA NIH HHS
• R01 HL154926 NHLBI NIH HHS
• R01 HL148436 NHLBI NIH HHS

• APACHE II
• Acute Respiratory Distress Syndrome
• Critical Care
• Endotracheal Intubation
• Intensive Care Unit
• Intubation Time
• Mechanical Ventilation
• SARS-CoV-2

• COVID-19
• intensive care
• percutaneous tracheostomy
• tracheostomy

• COVID-19
• Delayed intubation
• Early intubation
• Late intubation
• SARS-CoV-2

• COVID-19/epidemiology
• COVID-19/therapy
• Hospitals
• Humans
• Intubation, Intratracheal
• Pandemics
• Respiration, Artificial
• SARS-CoV-2

• Aerosols
• Humans
• Particle Size
• Personal Protective Equipment

• covid-19
• mortality
• logistic models

• T32 AI100852 NIAID NIH HHS
• UM1 AI069470 NIAID NIH HHS

• covid-19
• intubation complication
• mechanical vent
• prolonged intubation
• ventilation strategies

Coronavirus disease 2019 (COVID-19) pneumonia is an evolving disease. We will focus on the development of its pathophysiologic characteristics over time, and how these time-related changes determine modifications in treatment. In the emergency department: the peculiar characteristic is the coexistence, in a significant fraction of patients, of severe hypoxaemia, near-normal lung computed tomography imaging, lung gas volume and respiratory mechanics. Despite high respiratory drive, dyspnoea and respiratory rate are often normal. The underlying mechanism is primarily altered lung perfusion. The anatomical prerequisites for PEEP (positive end-expiratory pressure) to work (lung oedema, atelectasis, and therefore recruitability) are lacking. In the high-dependency unit: the disease starts to worsen either because of its natural evolution or additional patient self-inflicted lung injury (P-SILI). Oedema and atelectasis may develop, increasing recruitability. Noninvasive supports are indicated if they result in a reversal of hypoxaemia and a decreased inspiratory effort. Otherwise, mechanical ventilation should be considered to avert P-SILI. In the intensive care unit: the primary characteristic of the advance of unresolved COVID-19 disease is a progressive shift from oedema or atelectasis to less reversible structural lung alterations to lung fibrosis. These later characteristics are associated with notable impairment of respiratory mechanics, increased arterial carbon dioxide tension (P_aCO2), decreased recruitability and lack of response to PEEP and prone positioning.

COVID-19 pneumonia cannot be correctly described, analysed and treated if the time-factor is not taken into accounthttps://bit.ly/3AOKxc4

• covid-19/therapy
• covid-19/diagnosis
• coronavirus infections
• sars-cov-2
• practice guidelines as topic

• COVID-19
• Critical Care
• Humans
• Intensive Care Units
• SARS-CoV-2
• Sepsis/therapy

• Acute respiratory distress syndrome
• Barotrauma
• Coronavirus disease 2019
• Macklin effect
• Mechanical ventilation
• Pneumomediastinum
• Pneumothorax

• COVID-19
• clinical interventions
• critically ill patients
• mortality
• supportive care

• COVID-19
• Management
• Outcome
• Viral pneumonia

• COVID-19
• Extracorporeal membrane oxygenator
• Medications
• Renal replacement therapy
• Respiratory support
• Therapeutics

To determine whether time-to-intubation was associated with higher ICU mortality in patients with COVID-19 on mechanical ventilation due to respiratory insufficiency.

We conducted an observational, prospective, single-center study of patients with confirmed SARS-CoV-2 infection hospitalized with moderate to severe ARDS, connected to mechanical ventilation in the ICU between March 17 and July 31, 2020. We examined their general and clinical characteristics. Time-to-intubation was the time from hospital admission to endotracheal intubation.

We included 183 consecutive patients; 28% were female, and median age was 62 years old. Eighty-eight patients (48%) were intubated before 48 h (early) and ninety-five (52%) after 48 h (late). Patients intubated early had similar admission PaO₂/FiO₂ ratio (123 vs 99; p = 0.179) but were younger (59 vs 64; p = 0.013) and had higher body mass index (30 vs 28; p = 0.006) compared to patients intubated late. Mortality was higher in patients intubated late (18% versus 43%), with admission PaO₂/FiO₂ ratio < 100 mmHg (OR 5.2; p = 0.011), of older age (OR 1.1; p = 0.001), and with previous use of ACE inhibitors (OR 4.8; p = 0.026).

In COVID-19 patients, late intubation, Pafi <100, older age, and previous ACE inhibitors use were associated with increased ICU mortality.

• ARDS
• COVID-19
• Mechanical ventilation
• SARS-CoV-2

Supplemental Digital Content is available in the text.

There has been controversy about the timing and indications for intubation and mechanical ventilation in novel coronavirus disease 2019. This study assessed the effect of early intubation and mechanical ventilation on all-cause, inhospital mortality for coronavirus disease 2019 patients.

Multicenter retrospective cohort study.

Eleven municipal hospitals in New York City from March 1, 2020, to December 1, 2020.

Adult patients who tested positive for coronavirus disease 2019 in the emergency department were subsequently admitted. Patients with do-not-intubate orders at admission were excluded.

Intubation within 48 hours of triage and intubation at any point during hospital stay.

Data from 7,597 coronavirus disease 2019 patients were included; of these, 1,628 (21%) were intubated overall and 807 (11%) were intubated within 48 hours of triage. After controlling for available confounders, intubation rates for coronavirus disease 2019 patients varied significantly across hospitals and decreased steadily as the pandemic progressed. After nearest neighbor propensity score matching, intubation within 48 hours of triage was associated with higher all-cause mortality (hazard ratio, 1.30 [1.15–1.48]; p < 0.0001), as was intubation at any time point (hazard ratio, 1.62 [1.45–1.80]; p < 0.0001). Among intubated patients, intubation within 48 hours of triage was not significantly associated with differences in mortality (hazard ratio, 1.09 [0.94–1.26]; p = 0.26). These results remained robust to multiple sensitivity analyses.

Intubation within 48 hours of triage, as well as at any time point in the hospital course, was associated with increased mortality in coronavirus disease 2019 patients in this observational study.

• coronavirus disease 2019
• intubation; mechanical ventilation
• mortality
• retrospective cohort
• severe acute respiratory syndrome coronavirus-2

• Acute Respiratory Distress Syndrome
• Airway Extubation, Hypoxia
• Airway Management.
• Critical Care
• Intubation
• SARS-CoV-2

• Acute respiratory distress syndrome
• Acute respiratory failure
• Coronavirus
• Delayed
• Intensive care unit
• Pneumonia

• COVID-19/mortality
• COVID-19/therapy
• Cohort Studies
• Critical Illness
• Humans
• Intubation, Intratracheal/statistics & numerical data
• Time Factors
• Treatment Outcome

• 80-1/15.10.2020 Hellenic Foundation for Research and Innovation
• 2019 Hellenic Thoracic Society (GR)

• Acute respiratory distress syndrome
• COVID-19
• Intubation
• Mechanical ventilation
• Mortality