Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Nov 25, 2022; 11(6): 477-484
Published online Nov 25, 2022. doi: 10.5501/wjv.v11.i6.477
Clinical characteristics of COVID-19 patients who underwent tracheostomy and its effect on outcome: A retrospective observational study
Yudhyavir Singh, Kapil Dev Soni, Abhishek Singh, Nikita Choudhary, Fahina Perveen, Richa Aggarwal, Nishant Patel, Shailendra Kumar, Anjan Trikha
Yudhyavir Singh, Abhishek Singh, Nikita Choudhary, Fahina Perveen, Nishant Patel, Shailendra Kumar, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi 110029, India
Kapil Dev Soni, Richa Aggarwal, Department of Critical and Intensive Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi 110029, India
Anjan Trikha, Department of Anesthesia, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Singh A, Soni KD, Aggarwal R, Singh Y, Patel N, Kumar K, Chaudhary N, Perveen F, and Trikha A contributed to conception, study design, as well as data collection and evaluation; Singh A and Soni KD contributed to statistical analysis, and interpretation of data; Singh A, Singh Y, and Trikha A drafted the manuscript, which was revised by Soni KD; all authors have read and approved the final manuscript.
Institutional review board statement: The retrospective data presented in this study is the part of the project titled–Post discharge outcomes of COVID-19 patients following admission to the intensive care unit, which was approved by the institute ethics committee (Reference No. IEC-291/17.04.2020).
Informed consent statement: As the study was retrospective in nature, informed written consent from individual patients was waived.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: Data can be made available at proper request by writing to the authors at bikunrs77@gmail.com.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abhishek Singh, MD, Assistant Professor, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, 5th floor, Teaching block All India Institute of Medical Sciences, New Delhi 110029, India. bikunrs77@gmail.com
Received: April 20, 2022
Peer-review started: April 20, 2022
First decision: May 31, 2022
Revised: June 12, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: November 25, 2022
Processing time: 216 Days and 21.1 Hours
ARTICLE HIGHLIGHTS
Research background

The rapid increase in Coronavirus disease 2019 (COVID-19) patients has resulted in an increased number of patients with severe disease requiring prolonged ventilatory support and subsequently tracheostomy. Details regarding the timing, and safety of tracheostomy in the management of COVID-19 patients continue to evolve.

Research motivation

With the limited availability of literature regarding the outcomes of COVID-19 patients with tracheostomy, we attempted to study the clinical characteristics and multiple parameters affecting the outcomes in these patients.

Research objectives

Our research objective was to determine the all-cause mortality after tracheostomy and its relation with various risk factors in COVID-19 patients.

Research methods

We conducted a retrospective observational study at a tertiary care hospital. The study included 73 adult COVID-19 patients admitted to the ICU between 1 April, 2020 and 30 September, 2021 who underwent tracheostomy as a result of acute respiratory failure due to COVID-19.

Research results

Seventy-three adult patients were included in the study with an average age of 52 ± 16.67 years, of which 52% were male. The average time for admission to tracheostomy was 18.12 ± 12.98 days while intubation to tracheostomy was 11.97 ± 9 days. The mortality rate was 71.2% and only 28.8% of patients were discharged alive. Greater age, severe COVID-19, mechanical ventilation, presence of shock and acute kidney injury were associated with a poor prognosis; however, early tracheostomy in intubated patients resulted in a better outcome.

Research conclusions

The study showed that early tracheostomy (less than 10 days) was associated with reduced mortality with no added risk to the patient. Furthermore, the timing of tracheostomy should be decided on a case-by-case basis rather than following a strict rule.

Research perspectives

A well designed randomised controlled trial should be performed to elucidate the potential benefit of early tracheostomy in COVID-19 patients.