Coronavirus disease-2019 (COVID-19) has rapidly spread worldwide. High-flow nasal cannula therapy (HFNC) is a major oxygen supporting therapy for severely ill patients, but information regarding the timing of HFNC application is scarce, especially in elderly patients. We retrospectively analyzed the clinical data of 110 elderly patients (≥65 years) who received HFNC from Renmin Hospital of Wuhan University, People's Hospital of Xiantao City and Chinese Medicine Hospital of Shishou City in Hubei Province, China, and from Affiliated Hospital of Guangdong Medical University, People's Hospital of Yangjiang City, People's Hospital of Maoming City in Guangdong Province, China. Of the 110 patients, the median age was 71 years (IQR, 68-78) and 59.1% was male. Thirty-eight patients received HFNC when 200 mmHg < PO2/FiO2 ≤ 300 mmHg (early HFNC group), and 72 patients received HFNC treatment when 100 mmHg < PaO2/FiO2 ≤ 200 mmHg (late HFNC group). Compared with the late HFNC group, patients in the early HFNC group had a lower likelihood of developing severe ARDS, longer time from illness onset to severe ARDS and shorter duration of viral shedding after illness onset, as well as shorter lengths of ICU and hospital stay. Twenty-four patients died during hospitalization, of whom 22 deaths (30.6%) were in the late HFNC group and 2(5.3%) in the early HFNC group. It is concluded that the prognosis was better in severely ill elderly patients with COVID-19 receiving early compared to late HFNC. This suggests HFNC could be considered early in this disease process.

中文翻译：

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早期和晚期HFNC氧疗对老年COVID-19和ARDS患者的疗效

2019年冠状病毒病（COVID-19）已在全球迅速传播。高流量鼻插管疗法（HFNC）是重症患者的主要氧气支持疗法，但有关HFNC施用时间的信息很少，尤其是在老年患者中。回顾性分析武汉大学人民医院，仙桃市人民医院，湖北省石首市中医院，广东省医科大学附属医院收治的HFNC患者110例（≥65岁）的临床资料。大学，阳江市人民医院，广东省茂名市人民医院。在110名患者中，中位年龄为71岁（IQR，68-78岁），男性为59.1％。38例患者在200 mmHg < PO2 / FiO2≤300 mmHg（早期HFNC组），当100 mmHg <PaO2 / FiO2≤200 mmHg（晚期HFNC组）时有72例患者接受HFNC治疗。与晚期HFNC组相比，早期HFNC组患者发生严重ARDS的可能性较低，从发病到严重ARDS的时间更长，发病后病毒脱落的时间较短，ICU和住院时间较短。住院期间有24例患者死亡，其中HFNC晚期组22例死亡（30.6％），HFNC早期组2例（5.3％）。结论是，与晚期HFNC相比，早期接受COVID-19的重症老年患者的预后更好。这表明HFNC可以在该疾病过程的早期考虑。PaO2 / FiO2≤200 mmHg（HFNC组晚期）。与晚期HFNC组相比，早期HFNC组患者发生严重ARDS的可能性较低，从发病到严重ARDS的时间更长，发病后病毒脱落的时间较短，ICU和住院时间较短。住院期间有24例患者死亡，其中HFNC晚期组22例死亡（30.6％），HFNC早期组2例（5.3％）。结论是，与晚期HFNC相比，早期接受COVID-19的重症老年患者的预后更好。这表明HFNC可以在该疾病过程的早期考虑。PaO2 / FiO2≤200 mmHg（HFNC组晚期）。与晚期HFNC组相比，早期HFNC组患者发生严重ARDS的可能性较低，从发病到严重ARDS的时间更长，发病后病毒脱落的时间较短，ICU和住院时间较短。住院期间有24例患者死亡，其中HFNC晚期组22例死亡（30.6％），HFNC早期组2例（5.3％）。结论是，与晚期HFNC相比，早期接受COVID-19的重症老年患者的预后更好。这表明HFNC可以在该疾病过程的早期考虑。从发病到严重ARDS的时间更长，发病后病毒脱落的时间更短，ICU和住院时间也更短。住院期间有24例患者死亡，其中HFNC晚期组22例死亡（30.6％）和HFNC早期组2例（5.3％）死亡。结论是，与晚期HFNC相比，早期接受COVID-19的重症老年患者的预后更好。这表明HFNC可以在该疾病过程的早期考虑。从发病到严重ARDS的时间更长，发病后病毒脱落的时间更短，ICU和住院时间也更短。住院期间有24例患者死亡，其中HFNC晚期组22例死亡（30.6％），HFNC早期组2例（5.3％）。结论是，与晚期HFNC相比，早期接受COVID-19的重症老年患者的预后更好。这表明HFNC可以在该疾病过程的早期考虑。