Scientific article
Open access

Delayed intubation is associated with mortality in patients with severe COVID-19: A single-centre observational study in Switzerland

Published inAnaesthesia critical care & pain medicine, vol. 41, no. 4, 101092
Publication date2022-08
First online date2022-04-26

Introduction: Switzerland experienced two waves of COVID-19 in 2020, but with a different ICU admission and treatment management strategy. The timing of ICU admission and intubation remains a matter of debate in severe patients. The aim of our study was to describe the characteristics of ICU patients between two subsequent waves of COVID-19 who underwent a different management strategy and to assess whether the timing of intubation was associated with differences in mortality.

Patients and methods: We conducted a prospective observational study of all adult patients with acute respiratory failure due to COVID-19 who required intubation between the 9thof March 2020 and the 9thof January 2021 in the intensive care unit (ICU) at Geneva University Hospitals, Switzerland.

Results: Two hundred twenty-three patients were intubated during the study period; 124 during the first wave, and 99 during the second wave. Patients admitted to the ICU during the second wave had a higher SAPS II severity score (52.5 vs. 60; p = 0.01). The time from hospital admission to intubation was significantly longer during the second compared to the first wave (4 days [IQR, 1-7] vs. 2 days [IQR, 0-4]; p < 0.01). All-cause ICU mortality was significantly higher during the second wave (42% vs. 23%; p < 0.01). In a multivariate analysis, the delay between hospital admission and intubation was significantly associated with ICU mortality (OR 3.25 [95% CI, 1.38-7.67]; p < 0.05).

Conclusions: In this observational study, delayed intubation was associated with increased mortality in patients with severe COVID-19. Further randomised controlled trials are needed.

  • Acute respiratory distress syndrome
  • COVID-19
  • Delayed intubation
  • Intensive care unit
  • Mortality
  • Timing intubation
  • Adult
  • COVID-19 / therapy
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal
  • Respiratory Distress Syndrome
  • Switzerland / epidemiology
Citation (ISO format)
LE TERRIER, Christophe et al. Delayed intubation is associated with mortality in patients with severe COVID-19: A single-centre observational study in Switzerland. In: Anaesthesia critical care & pain medicine, 2022, vol. 41, n° 4, p. 101092. doi: 10.1016/j.accpm.2022.101092
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ISSN of the journal2352-5568

Technical informations

Creation08/13/2022 9:20:00 AM
First validation08/13/2022 9:20:00 AM
Update time03/16/2023 10:15:57 AM
Status update03/16/2023 10:15:55 AM
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