Clinical Outcomes in Patients Aged 80 Years or Older Receiving Non-Invasive Respiratory Support for Hypoxemic Acute Respiratory Failure Consequent to COVID-19

• Published in: Journal of clinical medicine Vol. 11; no. 5; p. 1372
• Main Authors: Vianello, Andrea, De Vita, Nello, Scotti, Lorenza, Guarnieri, Gabriella, Confalonieri, Marco, Bonato, Valeria, Molena, Beatrice, Maestrone, Carlo, Airoldi, Gianluca, Olivieri, Carlo, Sainaghi, Pier Paolo, Lionello, Federico, Arcaro, Giovanna, Della Corte, Francesco, Navalesi, Paolo, Vaschetto, Rosanna
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02-03-2022; MDPI
• Subjects: Clinical medicine; Clinical outcomes; Coronaviruses; COVID-19; Fatalities; Mortality; Respiratory failure; Italy; COVID-19; non-invasive respiratory support; acute respiratory failure; octogenarian patients
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11051372

As the clinical outcome of octogenarian patients hospitalised for COVID-19 is very poor, here we assessed the clinical characteristics and outcomes of patients aged 80 year or older hospitalised for COVID-19 receiving non-invasive respiratory support (NIRS). A multicentre, retrospective, observational study was conducted in seven hospitals in Northern Italy. All patients aged ≥80 years with COVID-19 associated hypoxemic acute respiratory failure (hARF) undergoing NIRS between 24 February 2020, and 31 March 2021, were included. Out of 252 study participants, 156 (61.9%) and 163 (64.6%) died during hospital stay and within 90 days from hospital admission, respectively. In this case, 228 (90.5%) patients only received NIRS (NIRS group), while 24 (9.5%) were treated with invasive mechanical ventilation (IMV) after NIRS failure (NIRS+IMV group). In-hospital mortality did not significantly differ between NIRS and NIRS+IMV group (61.0% vs. 70.8%, respectively;
= 0.507), while survival probability at 90 days was significantly higher for NIRS compared to NIRS+IMV patients (0.379 vs. 0.147;
0.0025). The outcome of octogenarian patients with COVID-19 receiving NIRS is quite poor. Caution should be used when considering transition from NIRS to IMV after NIRS failure.