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 Page 1/18 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. Read Full License 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..