Tracheostomy in 80 COVID-19 Patients: A Multicenter, Retrospective, Observational Study.

Area of Science:

• Critical Care Medicine
• Pulmonology
• Infectious Diseases

Background:

• The COVID-19 pandemic has increased the need for prolonged mechanical ventilation and tracheostomies.
• Optimal timing and outcomes of tracheostomy in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia patients remain unclear.

Purpose of the Study:

• To describe clinical characteristics and outcomes of COVID-19 patients undergoing elective tracheostomies.
• To compare outcomes between early (<14 days) and late (>14 days) tracheostomies.

Main Methods:

• Multi-center, retrospective, observational study of 80 COVID-19 patients in Hubei, China.
• Data collected on demographics, clinical course, tracheostomy details, and patient outcomes.
• Comparison of early versus late tracheostomy groups.

Main Results:

• Tracheostomies were performed by ICU physicians using percutaneous techniques at the bedside.
• The most common complication was tracheostoma bleeding (17.5%), with major bleeding in 5%.
• Early tracheostomy (<14 days) was associated with higher 60-day mortality (73.3% vs. 42.0%).

Conclusions:

• Elective tracheostomies are feasible in SARS-CoV-2 pneumonia patients with few major complications.
• Tracheostomy within 14 days of intubation is linked to increased mortality.
• Further research is needed to establish optimal tracheostomy timing in COVID-19.