Patients with COVID-19 achieved high success for ventilator liberation, functional recovery
In a new study, patients with COVID-19-associated respiratory failure who required mechanical ventilation had a better chance of recovery than patients without COVID-19, due to improved ventilator liberation and physical functioning.
“To our knowledge, our study is the first to report outcomes of patients with COVID-19 requiring mechanical ventilation beyond acute care hospitalization,” Tamas Dolinay, MD, PhD, pulmonologist at the Barlow Respiratory Hospital at the University of California, Los Angeles, and colleagues wrote in Chest. “We believe that studying this population is of critical importance because they represent a significant burden on the health care system.”
The retrospective cohort study included 242 patients who received mechanical ventilation who were discharged from the Barlow Respiratory Hospital from June 2020 to March 2021. Of these, 165 patients underwent tracheostomy and were considered for ventilator liberation. One hundred twenty-eight patients did not have COVID-19 (mean age, 69.3 years; 62.5% men) and 37 patients were admitted for COVID-19 (mean age, 66.2 years; 78.4% men).
The primary outcome was liberation from mechanical ventilation. Secondary outcomes included pulmonary function recovery, long-term acute care hospital length of stay and discharge disposition.
The adjusted rate of ventilator liberation was higher among patients with COVID-19 compared with patients without (91.4% vs. 56%) after the researchers adjusted for covariates.
The researchers reported a significantly higher adjusted mean change in Functional Status Score for the Intensive Care Unit among patients with COVID-19 compared with patients without (9.49 vs. 2.08; P < .001).
In addition, patients with COVID-19 had a shorter long-term acute care hospital length of stay, with an adjusted median of 39 days compared with 52 days for patients without COVID-19 (adjusted HR = 1.57; 95% CI, 1-2.46; P = .05).
Researchers observed no significant differences in home discharge (17.9 vs. 8.7), inpatient rehabilitation facility discharge (18.6 vs. 11.3), skilled nursing facility discharge (52 vs. 57), short-term acute care hospital transfer discharge (7.5 vs. 14.3) or death (3.9 vs. 8.6) between patients with and without COVID-19, but there was a trend toward requiring lower levels of care among patients with COVID-19, Dolinay and colleagues wrote.
“Our study provides new evidence that patients with COVID-19-associated respiratory failure requiring mechanical ventilation via tracheostomy have a better recovery potential than those without COVID-19, marked by improved ventilator liberation, better physical functioning and short long-term acute care hospital stay,” the researchers concluded.