Early Intubation and Increased Coronavirus Disease 2019 Mortality: A Propensity Score-Matched Retrospective Cohort...

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• Controversy exists regarding optimal timing for intubation in COVID-19 patients.
• Mechanical ventilation is a critical intervention for severe respiratory failure.

Purpose of the Study:

• To assess the impact of early intubation on in-hospital mortality for COVID-19 patients.
• To analyze the association between intubation timing and mortality outcomes.

Main Methods:

• Multicenter retrospective cohort study involving 7,597 adult COVID-19 patients.
• Data collected from eleven New York City hospitals between March and December 2020.
• Nearest neighbor propensity score matching used to control for confounders.

Main Results:

• Intubation within 48 hours of triage was linked to higher mortality (HR, 1.30; p < 0.0001).
• Intubation at any point during hospitalization also showed increased mortality (HR, 1.62; p < 0.0001).
• Among intubated patients, early intubation (within 48 hours) did not significantly alter mortality.

Conclusions:

• Early intubation and any-time intubation in COVID-19 patients were associated with increased mortality.
• Findings suggest caution regarding the timing of mechanical ventilation in COVID-19 management.