Clinical outcomes of COVID-19 patients after sequential oxygen therapy in Tertiary Medical College

Background: Acute respiratory failure is the main manifestation in patients with severe coronavirus disease (COVID-19), being hospitalized in an intensive care unit, and may even require invasive mechanical ventilation, which is associated with high mortality. The use of high-flow nasal oxygen (HFNO) for severe hypoxemic respiratory failure cases was limited in hospital setups. Its benefit to patients, compliance, complications, as well as comparison with non-invasive ventilation (NIV) mask were not studied. Patients and Methods: We included consecutive patients with COVID-19 acute respiratory failure who were categorized into three groups depending on admission oxygen saturation and respiratory rate for non-rebreather bag-mask (NRBM), HFNO, and NIV. All patients were observed for 2 weeks and defined parameters were noted. The mean and standard deviation were compared between the groups by using the ANOVA test; P-value <0.05 was considered as statistically significant. Results: The comparison of mean escalation of oxygen requirement on the 5th day showed a significant result (94.27 ± 1.7 vs. 92.16 ± 4.05 vs. 90.73 ± 2.49, respectively, P = 0.001). Similar findings were also found on the 10th day and 15th day of treatment. The NIV group showed a significant lack of compliance to oxygen therapy (P < 0.001) and also a significant incidence of complications (P < 0.001). Conclusion: NIV showed a significant amount of escalation in oxygen requirement, reduced therapy compliance, and associated complications in comparison to the NRBM and HFNO in COVID-19 settings.