HealthDay News — Among patients with severe COVID-19 who were deemed not likely to benefit from invasive mechanical ventilation (nIMV), no difference in 30-day mortality was observed for those receiving continuous positive airway pressure (CPAP) or oxygen therapy, according to a study published online Sept. 8 in EClinicalMedicine.
Patrick Bradley, from the Manchester University NHS Foundation Trust in the United Kingdom, and colleagues compared clinical outcomes for oxygen therapy versus CPAP in patients with COVID-19 who were nIMV in a retrospective cohort study. Patients were recruited during the first two waves of the U.K. COVID-19 pandemic in 2020 (March 1 to May 31 and Sept. 1 to Dec. 31, 2020). Data were included for 479 patients from seven hospitals; 246 received oxygen and 233 received CPAP.
The researchers found that 30-day mortality was 75.6 and 77.7 percent in the oxygen group and CPAP group, respectively. In the adjusted model, the lack of evidence for a treatment effect persisted (adjusted odds ratio, 0.84; 95 percent confidence interval, 0.57 to 1.23; P = 0.37). Overall, 49.8 percent of those receiving CPAP therapy discontinued therapy.
“We feel that reflection is warranted on the current treatment guidance and widespread application of CPAP for these patients who cannot be treated with mechanical ventilation,” a coauthor said in a statement. “Given the resources required to provide CPAP, it raises questions as to whether it should be provided to patients who are not suitable for mechanical ventilation, which has been commonplace during the COVID-19 pandemic.”
One author disclosed financial ties to the pharmaceutical and medical device industries.