Abstract Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of High flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission. Methods This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from March 10, 2020, to April 24, 2020 with moderate to severe respiratory failure treated with High Flow nasal therapy (HFNT). Primary outcome was prevention of intubation. Results Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. SF and chest Xray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital/ventilator associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of VAP/HAP was statistically higher in the progressed to intubation group. Conclusion HFNT use is associated with a reduction in the rate of Invasive mechanical ventilation and overall mortality in patients with COVID-19 infection.

中文翻译：

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使用高流量鼻腔疗法治疗COVID-19中度至严重低氧血症性呼吸衰竭

摘要侵入性机械与COVID-19的高死亡率相关。由于担心增加医护人员的传播，高流量鼻腔治疗（HFNT）的替代疗法已在世界范围内引起广泛争议，用于COVID-19大流行。方法这是一项回顾性分析，分析了从2020年3月10日至2020年4月24日在宾夕法尼亚州费城坦普尔大学医院住院的中，重度呼吸衰竭并接受高流量鼻腔治疗（HFNT）的患者。主要结果是预防插管。结果在445名COVID-19患者中，有104名符合我们的纳入标准。平均年龄为60.66（+13.50）岁，女性为49（47.12％），非洲裔美国人为53（50.96％），西班牙裔为23（22.12％）。吸烟者为43例（43.43％）。从第1天到第7天，SF和胸部X射线评分有统计学上的显着改善。104例中有67例（64.42％）能够避免我们队列中的有创机械通气。医院/呼吸机相关性肺炎的发生率为2.9％。总体而言，我们队列的死亡率为14.44％（n = 15），进展为插管组的为13（34.4％），非插管组的为2（2.9％）。进展为插管组的死亡率和VAP / HAP发生率在统计学上较高。结论HFNT的使用可降低COVID-19感染患者的有创机械通气率和总死亡率。在我们的队列中，死亡率为14.44％（n = 15），进展至插管组的死亡率为13（34.4％），非插管组的死亡率为2（2.9％）。进展为插管组的死亡率和VAP / HAP发生率在统计学上较高。结论HFNT的使用可降低COVID-19感染患者的有创机械通气率和总死亡率。在我们的队列中，死亡率为14.44％（n = 15），进展至插管组的死亡率为13（34.4％），非插管组的死亡率为2（2.9％）。进展为插管组的死亡率和VAP / HAP发生率在统计学上较高。结论HFNT的使用可降低COVID-19感染患者的有创机械通气率和总死亡率。