BACKGROUND Epidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina. METHODS We conducted a prospective, multi-center, observational study between July 2020-December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge. RESULTS We enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52-71], males 70%, Charlson comorbidity index was 2 [0-3], and length of stay in ICU was 42 [32-56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16-0.56], P < .001), Charlson comorbidity index (odds ratio 0.43 [95% CI 0.22-0.84], P < .01), mechanical ventilation duration in ICU (odds ratio 0.80 [95% CI 0.72-0.89], P < .001), renal failure (odds ratio 0.40 [95% CI 0.22-0.73], P = .003), and expiratory muscle weakness (odds ratio 0.35 [95% CI 0.19-0.62], P < .001) were independently associated with home discharge. CONCLUSIONS Most subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.

中文翻译：

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急性 COVID-19 后入住专门脱机中心的气管造口成年患者的流行病学。

背景 关于转诊至专门脱机中心 (SWC) 的 COVID-19 患者的流行病学数据很少，特别是在低收入和中等收入国家。我们的目的是描述阿根廷 SWC 收治受试者的临床特征、流行病学和结果。方法 我们于 2020 年 7 月至 2021 年 12 月期间在 12 个 SWC 进行了一项前瞻性、多中心、观察性研究。我们收集了人口特征、实验室结果、肺功能以及入院时对机械通气的依赖、拔管、机械通气脱机以及出院时的状态。建立了多重逻辑模型来预测家庭出院。结果 我们招募了 568 名在 COVID-19 急性期后接受气管造口术的成人受试者，他们被转移到 SWC。年龄为 62 [52-71]，男性 70%，Charlson 合并症指数为 2 [0-3]，ICU 住院时间为 42 [32-56] 天。在 315 名依赖呼吸机的受试者中，72.4% 脱机，427 名受试者（75.2%）拔管，366 名受试者（64.5%）出院回家。死亡率为6.0%。在多变量分析中，年龄（比值比 0.30 [95% CI 0.16-0.56]，P < .001）、Charlson 合并症指数（比值比 0.43 [95% CI 0.22-0.84]，P < .01）、机械通气持续时间ICU（比值比 0.80 [95% CI 0.72-0.89]，P < .001）、肾功能衰竭（比值比 0.40 [95% CI 0.22-0.73]，P = .003）和呼气肌无力（比值比 0.35 [ 95% CI 0.19-0.62]，P < .001）与出院独立相关。结论 大多数转移至 SWC 的 COVID-19 受试者已断奶、拔管并出院回家。年龄、高合并症负担、ICU机械通气时间延长、入院时肾衰竭和呼气肌无力与出院呈负相关。