CPAP Treatment In COVID-19 Patients: A Retrospective Observational Study In The Emergency Department
Capsoni et al.,
CPAP Treatment In COVID-19 Patients: A Retrospective Observational Study In The Emergency Department,
Research Square, doi:10.21203/rs.3.rs-113418/v1 (Preprint)
Small 52 patient retrospective study of patients with acute respiratory failure showing lower rates of intubation with HCQ.
risk of mechanical ventilation, 40.0% lower, RR 0.60, p = 0.30, treatment 12 of 40 (30.0%), control 6 of 12 (50.0%), NNT 5.0.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Capsoni et al., 1 Dec 2020, retrospective, Italy, preprint, 13 authors, average treatment delay 7.0 days.
Abstract: CPAP Treatment In COVID-19 Patients: A
Retrospective Observational Study In The
Emergency Department
Nicolò Capsoni ( nicolo.capsoni@gmail.com )
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda https://orcid.org/0000-0003-2758-4408
Daniele Privitera
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Annamaria Mazzone
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Chiara Airoldi
Università degli Studi del Piemonte Orientale Amedeo Avogadro: Universita degli Studi del Piemonte
Orientale Amedeo Avogadro
Valentina Albertini
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Laura Angaroni
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Marta Bergamaschi
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Alberto Dal Molin
Università degli Studi del Piemonte Orientale Amedeo Avogadro: Universita degli Studi del Piemonte
Orientale Amedeo Avogadro
Elisa Forni
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Federico Pierotti
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Eugenia Rocca
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ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Fabrizio Vincenti
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Andrea Bellone
ASST Grande Ospedale Metropolitano Niguarda: Azienda Socio Sanitaria Territoriale Grande Ospedale
Metropolitano Niguarda
Original Research
Keywords: CPAP, non-invasive ventilation, COVID-19, hypoxemic respiratory failure
Posted Date: November 30th, 2020
DOI: https://doi.org/10.21203/rs.3.rs-113418/v1
License: This work is licensed under a Creative Commons Attribution 4.0 International License.
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Page 2/18
Abstract
Background
During COVID-19 outbreak, with the increasing number of patients presenting with acute respiratory
failure (ARF), a large use of non-invasive positive pressure ventilation (NIPPV) was done in the
Emergency Departments (EDs) and medical wards despite the lack of recommendations. We aimed to
assess the use of continuous positive airway pressure (CPAP) in the ED. The primary endpoint was the
rate of CPAP failure and the need of endotracheal intubation (ETI). Secondary endpoints were in-hospital
mortality and intensive care unit (ICU) and in-hospital length of stay.
Methods
A retrospective observational study enrolling adult patients admitted to the ED of Niguarda Hospital,
Milan, Italy, with ARF due to COVID-19 pneumonia from March 18th to April 18th 2020, was conducted.
Only patients who strictly followed a local CPAP protocol were enrolled.
Results
A total of 52 patients were included in this study. 38 patients (73%) were judged eligible for ETI. 18
(34.6%) were intubated. 16 (30.8%) patients died: 7 (38.9%) and 9 (26.5%) in the ETI and non-ETI group
respectively. The median hospital length of stay was different in ETI and non-ETI patients: 26 days [IQR
16–37] vs 15 days..
Late treatment
is less effective
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