González, JessicaBenítez, Iván D.Gonzalo-Calvo, David deTorres, GerardBatlle, Jordi deGómez, SilviaMoncusí Moix, AnnaCarmona, PaolaSantisteve, SallyMonge, AidaGort Paniello, ClaraZuil, MaríaCabo Gambín, RamónManzano, Senra, CarlosVengoechea Aragoncillo, José JavierVaca, RafaelaMinguez, OlgaAguilar Cabello, MaríaFerrer Roca, RicardCeccato, AdrianFernández Barat, LaiaMotos, AnaRiera, JordiMenéndez, RosarioGarcía Gasulla, DarioPeñuelas, OscarLabarca, GonzaloCaballero, JesúsBarberà, CarmeTorres Martí, AntoniBarbé, FerranCIBERESUCICOVID Project (COV20/00110, ISCIII)2022-05-302022-05-302022-01-101364-8535https://hdl.handle.net/2445/186115Question: We evaluated whether the time between frst respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae. Materials and methods: Prospective cohort of critical COVID-19 patients on IMV. Patients were classifed as early intubation if they were intubated within the frst 48 h from the frst respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge. Results: We included 205 patients (140 with early IMV and 65 with delayed IMV). The median [p25;p75] age was 63 [56.0; 70.0] years, and 74.1% were male. The survival analysis showed a signifcant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29-4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42-4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean diference of −10.77 (95% CI −18.40 to −3.15), with a greater number of afected lobes (+1.51 [95% CI 0.89-2.13]) and a greater TSS (+4.35 [95% CI 2.41-6.27]) in the chest CT scan. Conclusions: Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the frst respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up. Keywords: COVID-19, ARDS, Critically ill patients, Early intubation, Respiratory management, Pulmonary sequelae11 p.application/pdfengcc-by (c) González, Jessica et al., 2022https://creativecommons.org/licenses/by/4.0/COVID-19Síndrome del destret respiratori de l'adultMalalts en estat críticIntubacióMalalties del pulmóCOVID-19Adult respiratory distress syndromeCritically illIntubationPulmonary diseasesinfo:eu-repo/semantics/article7220482022-05-30info:eu-repo/semantics/openAccess35012662