Risk Factors for Mortality in Mechanically Ventilated Patients with COVID-19 in a Mississippi Community Health System.

Abstract

To evaluate differences between survivors versus nonsurvivors undergoing mechanical ventilation for coronavirus disease 2019 (COVID-19)-associated respiratory failure at two community medical centers. 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. 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. 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.