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Table 2 Estimated effects of COVID period on the use of respiratory interventions and mortality in patients with acute respiratory distress comparing the COVID with the pre-COVID period

From: The COVID-19 pandemic: the effect on airway Management in non-COVID emergency patients

Outcomes

Pre-COVID

(n = 360)

COVID

(n = 333)

Adjusted OR (95%CI)

 

n

% (95%CI)

n

% (95%CI)

Respiratory interventions

 

Inverse PS score weighted

 Initial NIVHFNC use

15

4.2 (2.3, 6.8)

7

2.1 (0.8, 4.3)

0.40 (0.16, 1.00)

 NIVHFNC use

36

10.0 (7.1, 13.6)

21

6.3 (3.9, 9.5)

0.52 (0.29, 0.92)

a Intubation

55

21.7 (16.8, 27.3)

49

19.5 (14.8, 24.9)

0.94 (0.46, 1.32)

  Pneumonia

34

32.1 (23.3, 41.8)

29

26.4 (18.4, 35.6)

0.76 (0.42, 1.37)

  COPD/Asthma

8

8.6 (3.8, 16.2)

7

10.0 (4.1, 19.5)

1.18 (0.41, 3.42)

  Pulmonary edema

10

14.1 (7.0, 24.4)

18

23.4 (14.5, 34.4)

1.86 (0.79, 4.36)

Mortality

 

Multivariable logistic regression

 Non-survivor within 30 days

89

24.7 (20.4, 29.5)

43

12.9 (9.5, 17.0)

0.50 (0.33, 0.76)

  Pneumonia

75

37.4 (30.8, 44.4)

36

19.7 (14.1, 26.3)

0.48 (0.29, 0.77)

  COPD/Asthma

11

11.8 (6.2, 19.6)

2

2.6 (0.3, 9.2)

-b

  Pulmonary edema

3

4.0 (0.8, 11.2)

5

5.8 (1.9, 13.0)

-b

 In-hospital mortality

72

20.0 (16.0, 24.5)

40

12.0 (8.7, 16.0)

0.62 (0.40, 0.95)

  1. Note:- 95%CI for proportions were calculated by the Clopper Pearson Exact method. Pre-COVID = patients included during March–April 2019, COVID = patients included during March–April 2020. For respiratory interventions, inverse propensity score (PS) weighted analyses adjusted for age, gender, Charlson comorbidity index, respiratory rate, mean arterial pressure, and SpO2/FiO2 ratio. For mortality outcomes, multivariable logistic regression adjusted for age, gender, and Charlson comorbidity index. Pneumonia = community-, hospital-acquired or healthcare associated pneumonia. Pulmonary edema = congestive heart failure or volume overload. Bold fonts are statistically significant results. A non-null 95% confidence interval was considered significant
  2. Abbreviation: COPD, chronic obstructive pulmonary disease; OR, odds ratio; CI, confidence interval; COVID, coronavirus disease
  3. a Excludes patients with do-not-intubate orders: pre-COVID period n = 253, COVID period n = 251. Odds ratios of subgroups are crude ORs
  4. b Regression not performed due to insufficient events per variable