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Intubation Initiated in One in Five Who Died of COVID-19 in China

27 percent of patients only received nasal or face mask oxygen treatment before they died

WEDNESDAY, April 15, 2020 (HealthDay News) — Many patients who died from coronavirus disease 2019 (COVID-19) in China may have had delayed intubation, according to a research letter published online April 10 in JAMA Network Open.

Jianfeng Xie, M.D., Ph.D., from the Zhongda Hospital at Southeast University in Nanjing, China, and colleagues analyzed data from 168 patients with COVID-19-induced pneumonia who died at 21 hospitals in Wuhan, China, during Jan. 21 to 30, 2020. The authors sought to assess patient and treatment characteristics.

The researchers found that 75.0 percent of patients who died were male, with a median age of 70 years (95.8 percent were older than 50 years). Similarly, thee-quarters of patients (74.4 percent) had one or more comorbidity, with hypertension being the most common (50.0 percent), followed by diabetes (25.0 percent) and ischemic heart disease (18.5 percent). During hospitalization, all patients received oxygen therapy, with 27.4 percent receiving only nasal or face mask oxygen before they died, 34.5 percent receiving high-flow nasal oxygen therapy, and 42.9 percent receiving noninvasive ventilation. One in five patients (20.2 percent) were intubated and received invasive mechanical ventilation, while 1.2 percent received extracorporeal membrane oxygenation treatment. Age was not associated with intubation.

“Only approximately one-fifth of patients who died of COVID-19 received invasive mechanical ventilation and further aggressive respiratory support prior to death, indicating that many patients had delayed intubation,” the authors write.

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