Role of advanced respiratory support in acute respiratory failure in clinically frail patients with COVID-19

Future Microbiol. 2022 Jan:17:89-97. doi: 10.2217/fmb-2021-0226. Epub 2021 Dec 17.

Abstract

Background: The main aim of this study was to assess the efficacy of advanced respiratory support (ARS) for acute respiratory failure in do-not-attempt cardiopulmonary resuscitation order (DNACPR) COVID-19 patients. Methods: In this single-center study, the impact of different types of ARS modality, PaO2/FiO2 (PF) ratio, clinical frailty score (CFS) and 4C score on mortality was evaluated. Results: There was no significant difference in age, type of ARS modality, PF ratio and 4C scores between those who died and those who survived. Overall survival rates/hospital discharge of patients still requiring ARS at 5 and 7 days post admission were 20 and 17%, respectively. Conclusion: Our study showed that ARS can be a useful tool in frail, elderly and high-risk COVID-19 patients irrespective of high 4C mortality score.

Keywords: COVID-19; ISARIC 4C mortality score; PaO2/FiO2 Ratio; acute respiratory support; clinical frailty score (CFS); invasive mechanical ventilation; noninvasive mechanical ventilation (CPAP & HFNO).

MeSH terms

  • COVID-19* / mortality
  • COVID-19* / therapy
  • Frailty*
  • Humans
  • Respiratory Insufficiency* / therapy
  • Resuscitation Orders