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Open AccessArticle

Clinical Significance of Timing of Intubation in Critically Ill Patients with COVID-19: A Multi-Center Retrospective Study

1
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
2
Department of Internal Medicine, Daegu Veterans Hospital, Daegu 42835, Korea
3
Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Korea
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 2847; https://doi.org/10.3390/jcm9092847
Received: 31 July 2020 / Revised: 27 August 2020 / Accepted: 31 August 2020 / Published: 2 September 2020
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
The effect of intubation timing on the prognosis of critically ill patients with coronavirus 2019 (COVID-19) is not yet well understood. We investigated whether early intubation is associated with the survival of COVID-19 patients with acute respiratory distress syndrome (ARDS). This multicenter, retrospective, observational study was done on 47 adult COVID-19 patients with ARDS who were admitted to the intensive care unit (ICU) in Daegu, Korea between February 17 and April 23, 2020. Clinical characteristics and in-hospital mortality were compared between the early intubation and initially non-intubated groups, and between the early and late intubation groups, respectively. Of the 47 patients studied, 23 (48.9%) were intubated on the day of meeting ARDS criteria (early intubation), while 24 (51.1%) were not initially intubated. Eight patients were never intubated during the in-hospital course. Median follow-up duration was 46 days, and 21 patients (44.7%) died in the hospital. No significant difference in in-hospital mortality rate was noted between the early group and initially non-intubated groups (56.5% vs. 33.3%, p = 0.110). Furthermore, the risk of in-hospital death in the early intubation group was not significantly different compared to the initially non-intubated group on multivariate adjusted analysis (p = 0.385). Results were similar between early and late intubation in the subgroup analysis of 39 patients treated with mechanical ventilation. In conclusion, in this study of critically ill COVID-19 patients with ARDS, early intubation was not associated with improved survival. This result may help in the efficient allocation of limited medical resources, such as ventilators. View Full-Text
Keywords: COVID-19; acute respiratory distress syndrome; intubation; respiratory failure; mortality; intensive care units COVID-19; acute respiratory distress syndrome; intubation; respiratory failure; mortality; intensive care units
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MDPI and ACS Style

Lee, Y.H.; Choi, K.-J.; Choi, S.H.; Lee, S.Y.; Kim, K.C.; Kim, E.J.; Lee, J. Clinical Significance of Timing of Intubation in Critically Ill Patients with COVID-19: A Multi-Center Retrospective Study. J. Clin. Med. 2020, 9, 2847. https://doi.org/10.3390/jcm9092847

AMA Style

Lee YH, Choi K-J, Choi SH, Lee SY, Kim KC, Kim EJ, Lee J. Clinical Significance of Timing of Intubation in Critically Ill Patients with COVID-19: A Multi-Center Retrospective Study. Journal of Clinical Medicine. 2020; 9(9):2847. https://doi.org/10.3390/jcm9092847

Chicago/Turabian Style

Lee, Yong H.; Choi, Keum-Ju; Choi, Sun H.; Lee, Shin Y.; Kim, Kyung C.; Kim, Eun J.; Lee, Jaehee. 2020. "Clinical Significance of Timing of Intubation in Critically Ill Patients with COVID-19: A Multi-Center Retrospective Study" J. Clin. Med. 9, no. 9: 2847. https://doi.org/10.3390/jcm9092847

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