High-flow oxygen therapy in elderly patients infected with SARS-CoV2 with a contraindication for transfer to an intensive care unit: A preliminary report. (July 2021)

• Record Type: Journal Article
• Authors: Lagier, Jean-Christophe; Amrane, Sophie; Mailhe, Morgane; Gainnier, Marc; Arlotto, Sylvie; Gentile, Stéphanie; Raoult, Didier
• Is Part Of: International journal of infectious diseases. Volume 108(2021)
• Page Start: 1
• Page End: 3
• Publication Date: 2021-07
• Subjects: SARS-CoV2 -- COVID-19 -- Elderly patients -- High-flow oxygen therapy -- Conventional hospital ward; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.03.087
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Severe COVID-19 infections occur mostly in patients over 65 years of age. Elderly patients with comorbidities are frequently non eligible for ICU transfer. HFNO saved the lives of one-third of COVID-19 patients noneligible for ICU transfer. Abstract: Objectives: In a conventional hospital ward, we used high-flow nasal oxygen (HFNO) to treat elderly COVID-19 patients noneligible for intensive care unit transfer. Methods: This study was conducted in the Institut Hospitalo-Universitaire Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille (AP-HM), France. We used high-flow nasal oxygen (HFNO) in our conventional infectious disease ward from 15 September 2020 for elderly patients noneligible for intensive care unit transfer. Results: Of the 44 patients (median age 83 years (57–94), mean: 80.25), 61.4% (27/44) were men. The median Charlson score was 7 (1–15). The median of the NEWS-2 score upon admission was 8 (3–11) and was 10 at the time of initiation of HFNO. The median PaO2/FiO2 ratio was 103 (71–151) prior to HNFO initiation. Among the 44 patients, 16 patients (36.4%) had been weaned from HFNO, and 28 patients had died (63.6%). Conclusions: In this preliminary report, we observed that HFNO saved the lives of one-third of elderly COVID-19 patients who would have systematically died.