LAUSR

Because of a high mortality rate seen in patients intubated for coronavirus disease 2019–associated respiratory failure, the authors sought to evaluate the mortality rate specific to their institution and compare the characteristics of survivors versus nonsurvivors to attempt to elucidate whether differences existed in each group. They sought to specifically determine whether differences in ventilation strategies and/or timing of intubation affected survival. The results showed a numerical difference in the timing of intubation trending toward improved survival in those intubated sooner versus later in their disease course. Abstract Objective To evaluate differences between survivors versus nonsurvivors undergoing mechanical ventilation for coronavirus disease 2019 (COVID-19)–associated respiratory failure at two community medical centers. Methods This was a multicenter, retrospective cohort analysis of all adult patients mechanically ventilated for COVID-19–associated respiratory failure in two community hospital intensive care units in southern Mississippi from March 15, 2020 through October 10, 2020. Results Among 56 patients requiring mechanical ventilation, the mortality rate was 75% (42/56). Expired patients were intubated later (2 vs 5 days, 95% confidence interval [CI] 6.314–0.8041, P = 0.0983), had lower PaO2:FiO2 ratios (65 vs 77.5 mm Hg, 95% CI 36.08–59.03, P = 0.6305), and tolerated lower levels of positive end-expiratory pressure (7.9 vs 12.6 cm H2O, 95% CI 0.1373–6.722, P = 0.0415) at the time of intubation. Conclusions Our results suggest that earlier intubation may be associated with reduced mortality in patients with COVID-19-associated respiratory failure and should be further evaluated in the form of a randomized controlled trial.