Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study
Authors: Reyes Luis Felipe , Murthy Srinivas , Garcia-Gallo Esteban , Merson Laura , Ibáñez-Prada Elsa D. , Rello Jordi , Fuentes Yuli V. , Martin-Loeches Ignacio , Bozza Fernando , Duque Sara , Taccone Fabio S. , Fowler Robert A. , Kartsonaki Christiana , Gonçalves Bronner P. , Citarella Barbara Wanjiru , Aryal Diptesh , Burhan Erlina , Cummings Matthew J. , Delmas Christelle , Diaz Rodrigo , Figueiredo-Mello Claudia , Hashmi Madiha , Panda Prasan Kumar , Jiménez Miguel Pedrera , Rincon Diego Fernando Bautista , Thomson David , Nichol Alistair , Marshall John C. , Olliaro Piero L. ,   the ISARIC Characterization Group, Abbas Ali , Abdukahil Sheryl Ann , Abe Ryuzo , Abel Laurent , Absil Lara , Acharya Subhash , Acker Andrew , Adrião Diana , Al Ageel Saleh , Ahmed Shakeel , Ainscough Kate , Aisa Tharwat , Hssain Ali Ait , Tamlihat Younes Ait , Akimoto Takako , Akmal Ernita , Al Qasim Eman , Alalqam Razi , Al-dabbous Tala , Alegesan Senthilkumar , Alegre Cynthia , Alessi Marta , Alex Beatrice , Alexandre Kévin , Al-Fares Abdulrahman , Alfoudri Huda , Ali Imran , Shah Naseem Ali , Alidjnou Kazali Enagnon , Aliudin Jeffrey , Alkhafajee Qabas , Allavena Clotilde , Allou Nathalie , Altaf Aneela , Alves João , Alves João Melo , Alves Rita , Cabrita Joana Alves , Amaral Maria , Ampaw Phoebe , Andini Roberto , Andréjak Claire , Angheben Andrea , Angoulvant François , Ansart Séverine , Antonelli Massimo , de Brito Carlos Alexandre Antunes , Apriyana Ardiyan , Arabi Yaseen , Aragao Irene , Araujo Carolline , Arcadipane Antonio , Archambault Patrick , Arenz Lukas , Arlet Jean-Benoît , Arnold-Day Christel , Arora Lovkesh , Arora Rakesh , Artaud-Macari Elise , Aryal Diptesh , Asensio Angel , Asif Namra , Asim Mohammad , Assie Jean Baptiste , Atique Anika , Attanyake A. M. Udara Lakshan , Auchabie Johann , Aumaitre Hugues , Auvet Adrien , Azemar Laurène , Azoulay Cecile , Bach Benjamin , Bachelet Delphine , Badr Claudine , Baig Nadia , Baillie J. Kenneth , Bak Erica , Bakakos Agamemnon , Bal Andriy , Balan Valeria , Bani-Sadr Firouzé , Barbalho Renata , Barclay Wendy S. , Barnikel Michaela , Barrasa Helena , Barrelet Audrey , Barrigoto Cleide , Bartoli Marie , Baruch Joaquín , Basmaci Romain , Battaglini Denise , Bauer Jules , Dow Denisse Bazan , Beane Abigail , Bedossa Alexandra , Begum Husna , Behilill Sylvie , Beishuizen Albertus , Beljantsev Aleksandr , Bellemare David , Beltrame Anna , Beluze Marine , Benech Nicolas , Benkerrou Dehbia , Bennett Suzanne , Bento Luís , Berdal Jan-Erik , Bergeaud Delphine , Bergin Hazel , Sobrino José Luis Bernal , Bertoli Giulia , Bertolino Lorenzo , Bessis Simon , Bevilcaqua Sybille , Bezulier Karine , Bhatt Amar , Bhavsar Krishna , Bianco Claudia , Singh Moirangthem Bikram , Humaid Felwa Bin , Bissuel François , Bitker Laurent , Bitton Jonathan , Blanco-Schweizer Pablo , Blier Catherine , Bloos Frank , Blot Mathieu , Boccia Filomena , Bodenes Laetitia , Bogaert Debby , Boivin Anne-Hélène , Bolze Pierre-Adrien , Bompart François , Borges Diogo , Borie Raphaël , Bosse Hans Martin , Botelho-Nevers Elisabeth , Bouadma Lila , Bouchaud Olivier , Bouchez Sabelline , Bouhmani Dounia , Bouhour Damien , Bouiller Kévin , Bouillet Laurence , Bouisse Camile , Boureau Anne-Sophie , Bourke John , Bouscambert Maude , Bousquet Aurore , Bouziotis Jason , Boxma Bianca , Boyer-Besseyre Marielle , Boylan Maria , Braconnier Axelle , Braga Cynthia , Brandenburger Timo , Monteiro Filipa Brás , Brazzi Luca , Breen Dorothy , Breen Patrick , Brickell Kathy , Browne Alex , Browne Shaunagh , Brusse-Keizer Marjolein , Buchtele Nina , Buesaquillo Christian , Bugaeva Polina , Buisson Marielle , Burrell Aidan , Bustos Ingrid G. , Butnaru Denis , Cabie André , Cabral Susana , Caceres Eder , Cadoz Cyril , Garcês Rui Caetano , Calligy Kate , Calvache Jose Andres , Camões João , Campana Valentine , Campbell Paul , Canepa Cecilia , Cantero Mireia , Caraux-Paz Pauline , Cárcel Sheila , Cardellino Chiara Simona , Cardoso Filipa , Cardoso Filipe , Cardoso Nelson , Cardoso Sofia , Carelli Simone , Carlier Nicolas , Carmoi Thierry , Carney Gayle , Carqueja Inês , Carret Marie-Christine , Carrier François Martin , Carroll Ida , Carson Gail , Casanova Maire-Laure , Cascão Mariana , Casey Siobhan , Casimiro José , Cassandra Bailey , Castañeda Silvia , Castanheira Nidyanara , Castor-Alexandre Guylaine , Castrillón Henry , Castro Ivo , Catarino Ana , Catherine François-Xavier , Cattaneo Paolo , Cavalin Roberta , Cavalli Giulio Giovanni , Cavayas Alexandros , Ceccato Adrian , Cervantes-Gonzalez Minerva , Chair Anissa , Chakveatze Catherine , Chan Adrienne , Chand Meera , Auger Christelle Chantalat , Chapplain Jean-Marc , Chas Julie , Chaudry Mobin , Iñiguez Jonathan Samuel Chávez , Chen Anjellica , Chen Yih-Sharng , Cheng Matthew Pellan , Cheret Antoine , Chiarabini Thibault , Chica Julian , Chirouze Catherine , Chiumello Davide , Cho Sung-Min , Cholley Bernard , Chopin Marie-Charlotte , Cidade Jose Pedro , Herreros José Miguel Cisneros , Ciullo Anna , Clarke Emma , Clarke Jennifer , Clohisey Sara , Cobb Perren J. , Codan Cassidy , Cody Caitriona , Coelho Alexandra , Coles Megan , Colin Gwenhaël , Collins Michael , Colombo Sebastiano Maria , Combs Pamela , Connor Marie , Conrad Anne , Contreras Sofía , Conway Elaine , Cooke Graham S. , Copland Mary , Cordel Hugues , Corley Amanda , Cornelis Sabine , Cornet Alexander Daniel , Corpuz Arianne Joy , Cortegiani Andrea , Corvaisier Grégory , Costigan Emma , Couffignal Camille , Couffin-Cadiergues Sandrine , Courtois Roxane , Cousse Stéphanie , Cregan Rachel , Croonen Sabine , Crowl Gloria , Crump Jonathan , Cruz Claudina , Bermúdez Juan Luis Cruz , Rojo Jaime Cruz , Csete Marc , Cullen Ailbhe , Curley Ger , Curlier Elodie , Curran Colleen , Custodio Paula , da Silva Filipe Ana , Da Silveira Charlene , Dabaliz Al-Awwab , Dagens Andrew , Dahly Darren , Dalton Heidi , Dalton Jo , Daly Seamus , Damas Juliana , Daneman Nick , Daniel Corinne , Dankwa Emmanuelle A. , Dantas Jorge , D’Aragon Frédérick , de Loughry Gillian , de Mendoza Diego , De Montmollin Etienne , de Oliveira França Rafael Freitas , de Pinho Oliveira Ana Isabel , De Rosa Rosanna , de Silva Thushan , de Vries Peter , Deacon Jillian , Dean David , Debard Alexa , Debray Marie-Pierre , DeCastro Nathalie , Dechert William , Deconninck Lauren , Decours Romain , Defous Eve , Delacroix Isabelle , Delaveuve Eric , Delavigne Karen , Dell’Amore Andrea , Delobel Pierre , Delsing Corine , Demonchy Elisa , Denis Emmanuelle , Deplanque Dominique , Depuydt Pieter , Descamps Diane , Desvallées Mathilde , Dewayanti Santi , Dhanger Pathik , Diallo Alpha , Diamantis Sylvain , Dias André , Diaz Juan Jose , Diaz Priscila , Didier Kévin , Diehl Jean-Luc , Dieperink Wim , Dimet Jérôme , Dinot Vincent , Diop Fara , Diouf Alphonsine , Dishon Yael , Djossou Félix , Docherty Annemarie B. , Doherty Helen , Dondorp Arjen M. , Donnelly Christl A. , Donnelly Maria , Donohue Chloe , Donohue Sean , Donohue Yoann , Doran Peter , Dorival Céline , D’Ortenzio Eric , Douglas James Joshua , Dournon Nathalie , Downer Triona , Downey Joanne , Downing Mark , Drake Tom , Driscoll Aoife , Fonseca Claudio Duarte , Dubee Vincent , Dubos François , Ducancelle Alexandre , Dudman Susanne , Dunand Paul , Dunning Jake , Duplaix Mathilde , Durante-Mangoni Emanuele , Durham Lucian , Dussol Bertrand , Duthoit Juliette , Duval Xavier , Dyrhol-Riise Anne Margarita , Echeverria-Villalobos Marco , Egan Siobhan , Eira Carla , Sanharawi Mohammed El , Elapavaluru Subbarao , Elharrar Brigitte , Ellerbroek Jacobien , Eloy Philippine , Elshazly Tarek , Enderle Isabelle , Endo Tomoyuki , Engelmann Ilka , Enouf Vincent , Epaulard Olivier , Escher Martina , Esperatti Mariano , Esperou Hélène , Santo Catarina Espírito , Esposito-Farese Marina , Estevão João , Etienne Manuel , Ettalhaoui Nadia , Everding Anna Greti , Evers Mirjam , Fabre Isabelle , Fabre Marc , Faheem Amna , Fahy Arabella , Fairfield Cameron J. , Fakar Zul , Fareed Komal , Faria Pedro , Farooq Ahmed , Fatoni Arie Zainul , Faure Karine , Favory Raphaël , Fayed Mohamed , Feely Niamh , Feeney Laura , Fernandes Jorge , Fernandes Marília Andreia , Fernandes Susana , Ferrand François-Xavier , Devouge Eglantine Ferrand , Ferrão Joana , Ferraz Mário , Ferreira Benigno , Ferreira Bernardo , Ferreira Isabel , Ferreira Sílvia , Ferrer-Roca Ricard , Ferriere Nicolas , Ficko Céline , Fiorda Juan , Flament Thomas , Flateau Clara , Fletcher Tom , Florio Letizia Lucia , Flynn Deirdre , Foley Claire , Foley Jean , Fomin Victor , Fonseca Tatiana , Fontela Patricia , Forsyth Simon , Foster Denise , Foti Giuseppe , Fourn Erwan , Fraher Marianne , Franch-Llasat Diego , Fraser Christophe , Fraser John F. , Freire Marcela Vieira , Ribeiro Ana Freitas , French Craig , Friedrich Caren , Fry Stéphanie , Fuentes Nora , Fukuda Masahiro , G Argin , Gaborieau Valérie , Gaci Rostane , Gagliardi Massimo , Gagnard Jean-Charles , Gagneux-Brunon Amandine , Gaião Sérgio , Skeie Linda Gail , Gallagher Phil , Gamble Carrol , Garan Arthur , Garcia Rebekha , Barrio Noelia García , Garimella Navya , Garot Denis , Garrait Valérie , Gauli Basanta , Gault Nathalie , Gavin Aisling , Gavrylov Anatoliy , Gaymard Alexandre , Gebauer Johannes , Geraud Eva , Morlaes Louis Gerbaud , Germano Nuno , Ghosn Jade , Giani Marco , Gibson Jess , Gigante Tristan , Gilg Morgane , Gilroy Elaine , Giordano Guillermo , Girvan Michelle , Gissot Valérie , Glikman Daniel , Glybochko Petr , Gnall Eric , Goco Geraldine , Goehringer François , Goepel Siri , Goffard Jean-Christophe , Golob Jonathan , Gómez-Junyent Joan , Gominet Marie , Gonzalez Alicia , Gordon Patricia , Gorenne Isabelle , Goubert Laure , Goujard Cécile , Goulenok Tiphaine , Grable Margarite , Graf Jeronimo , Grandin Edward Wilson , Granier Pascal , Grasselli Giacomo , Green Christopher A. , Greene Courtney , Greenhalf William , Greffe Segolène , Grieco Domenico Luca , Griffee Matthew , Griffiths Fiona , Groenendijk Albert , Lordemann Anja Grosse , Gruner Heidi , Gu Yusing , Guedj Jérémie , Guego Martin , Guellec Dewi , Guerguerian Anne-Marie , Guerreiro Daniela , Guery Romain , Guillaumot Anne , Guilleminault Laurent , de Castro Maisa Guimarães , Guimard Thomas , Haalboom Marieke , Haber Daniel , Habraken Hannah , Hachemi Ali , Hadri Nadir , Haidri Fakhir , Hakak Sheeba , Hall Adam , Hall Matthew , Halpin Sophie , Hameed Jawad , Hamer Ansley , Hamidfar Rebecca , Hammond Terese , Haniffa Rashan , Hardwick Hayley , Harrison Ewen M. , Harrison Janet , Harrison Samuel Bernard Ekow , Hasan Mohd Shahnaz , Hashmi Junaid , Hayat Muhammad , Hayes Ailbhe , Hays Leanne , Heerman Jan , Heggelund Lars , Hendry Ross , Hennessy Martina , Hentzien Maxime , Hershey Andrew , Hesstvedt Liv , Hidayah Astarini , Higgins Dawn , Higgins Eibhilin , Higgins Rupert , Hinchion Rita , Hinton Samuel , Hitoto Hikombo , Ho Antonia , Hoctin Alexandre , Hoffmann Isabelle , Hoiting Oscar , Holt Rebecca , Holter Jan Cato , Horby Peter , Horcajada Juan Pablo , Hoshino Koji , Hoshino Kota , Houas Ikram , Hough Catherine L. , Hsu Jimmy Ming-Yang , Hulot Jean-Sébastien , Huo Stella , Hurd Abby , Hussain Iqbal , Ijaz Samreen , Ikram Arfan , Illes Hajnal-Gabriela , Imbert Patrick , Imran Mohammad , Sikander Rana Imran , Imtiaz Aftab , Inácio Hugo , Dominguez Carmen Infante , Ippolito Mariachiara , Isgett Sarah , Isidoro Tiago , Isnard Margaux , Ivulich Daniel , Jaafar Danielle , Jaafoura Salma , Jabot Julien , Jackson Clare , Jamieson Nina , Jaquet Pierre , Jaud-Fischer Coline , Jaureguiberry Stéphane , Jego Florence , Jenum Synne , García Ruth N. Jorge , Joseph Cédric , Joseph Mark , Joshi Swosti , Jourdain Mercé , Jouvet Philippe , Jung Anna , Juzar Dafsah , Kafif Ouifiya , Kaguelidou Florentia , Kali Sabina , Kalomoiri Smaragdi , Kandamby Darshana Hewa , Kandel Chris , Kanwal Darakhshan , Kataria Anant , Katz Kevin , Kay Christy , Keane Hannah , Keating Seán , Kelly Andrea , Kelly Aoife , Kelly Claire , Kelly Niamh , Kelly Sadie , Kelly Yvelynne , Kelsey Maeve , Kennon Kalynn , Kernan Maeve , Kerroumi Younes , Keshav Sharma , Khalid Imrana , Khalid Osama , Khalil Antoine , Khan Coralie , Khan Irfan , Khan Quratul Ain , Khanal Sushil , Khatak Abid , Khawaja Amin , Kho Michelle E. , Khoo Saye , Khoso Nasir , Kida Yuri , Kiiza Peter , Granerud Beathe Kiland , Kildal Anders Benjamin , Kimmoun Antoine , Kindgen-Milles Detlef , Kitamura Nobuya , Klenerman Paul , Klont Rob , Bekken Gry Kloumann , Knight Stephen R. , Kobbe Robin , Kodippily Chamira , Vasconcelos Malte Kohns , Koirala Sabin , Kosgei Caroline , Kpangon Arsène , Krawczyk Karolina , Kruglova Oksana , Kumar Deepali , Kumar Mukesh , Vijayaraghavan Bharath Kumar Tirupakuzhi , Vecham Pavan Kumar , Kuriakose Dinesh , Kurtzman Ethan , Kutsogiannis Demetrios , Kutsyna Galyna , Kyriakoulis Konstantinos , Lachatre Marie , Lacoste Marie , Laffey John G. , Lagrange Marie , Laine Fabrice , Lairez Olivier , Lakhey Sanjay , Lalueza Antonio , Lambert Marc , Lamontagne François , Langelot-Richard Marie , Langlois Vincent , Lantang Eka Yudha , Lanza Marina , Laouénan Cédric , Laribi Samira , Lariviere Delphine , Lasry Stéphane , Latif Naveed , Launay Odile , Laureillard Didier , Lavie-Badie Yoan , Law Andrew , Lawrence Cassie , Lawrence Teresa , Le Minh , Le Bihan Clément , Le Bris Cyril , Le Falher Georges , Le Fevre Lucie , Le Hingrat Quentin , Le Maréchal Marion , Le Mestre Soizic , Le Moal Gwenaël , Le Moing Vincent , Le Nagard Hervé , Le Turnier Paul , Leal Ema , Santos Marta Leal , Lee James , Lee Jennifer , Lee Su Hwan , Lee Todd C. , Leeming Gary , Lefebvre Bénédicte , Lefebvre Laurent , Lefèvre Benjamin , LeGac Sylvie , Lelievre Jean-Daniel , Lellouche François , Lemaignen Adrien , Lemee Véronique , Lemeur Anthony , Lemmink Gretchen , Lennon Jenny , León Rafael , Leone Marc , Leone Michela , Lescure François-Xavier , Lesens Olivier , Lesouhaitier Mathieu , Lester-Grant Amy , Levy Bruno , Levy Yves , Levy-Marchal Claire , Lewandowska Katarzyna , L’Her Erwan , Bassi Gianluigi Li , Liaquat Ali , Liegeon Geoffrey , Lim Wei Shen , Lima Chantre , Lina Bruno , Lind Andreas , Lingas Guillaume , Lion-Daolio Sylvie , Liu Keibun , Livrozet Marine , Lizotte Patricia , Loforte Antonio , Lolong Navy , Lopes Diogo , Loschner Anthony L. , Loubet Paul , Loufti Bouchra , Louis Guillame , Lourenco Silvia , Lovelace-Macon Lara , Lowik Marije , Lucet Jean Christophe , Bermejo Carlos Lumbreras , Luna Carlos M. , Luong Liem , Luque Nestor , Luton Dominique , Lwin Nilar , Lyons Ruth , Maasikas Olavi , Mabiala Oryane , Machado Moïse , Machado Sara , Macheda Gabriel , Madiha Hashmi , de la Calle Guillermo Maestro , Mahieu Rafael , Mahy Sophie , Maia Ana Raquel , Maier Lars S. , Maillet Mylène , Maitre Thomas , Malfertheiner Maximilian , Malik Nadia , Mallon Paddy , Maltez Fernando , Malvy Denis , Manda Victoria , Mandelbrot Laurent , Mankikian Julie , Manning Edmund , Manuel Aldric , Sant Ceila Maria , Malaque Ana , Marino Daniel , Marino Flávio , Markowicz Samuel , Marques Ana , Marquis Catherine , Marsh Brian , Marsh Laura , Marshal Megan , Martelli Celina Turchi , Martin Emily , Martin-Blondel Guillaume , Martinot Martin , Martins Ana , Martins João , Martins Nuno , Rego Caroline Martins , Martucci Gennaro , Martynenko Olga , Marwali Eva Miranda , Maslove David , Mason Sabina , Masood Sobia , Nor Basri Mat , Nor Basri Mat , Matan Moshe , Mathew Meghena , Mathieu Daniel , Mattei Mathieu , Matulevics Romans , Maulin Laurence , Maxwell Michael , Maynar Javier , Mazzoni Thierry , Mc Evoy Natalie , Mc Sweeney Lisa , McArthur Colin , McArthur Colin , McCarthy Aine , McCarthy Anne , McCloskey Colin , McConnochie Rachael , McDermott Sherry , McDonald Sarah E. , McElroy Aine , McElwee Samuel , McEneany Victoria , McGeer Allison , McKay Chris , McKeown Johnny , McLean Kenneth A. , McNally Paul , McNicholas Bairbre , McPartlan Elaine , Meaney Edel , Mear-Passard Cécile , Mechlin Maggie , Atif Minahel , Meher Maqsood , Mele Ferruccio , Melo Luis , Memon Kashif , Mendes Joao Joao , Menkiti Ogechukwu , Menon Kusum , Mentré France , Mentzer Alexander J. , Mercier Emmanuelle , Mercier Noémie , Merckx Antoine , Mergeay-Fabre Mayka , Mergler Blake , Mesquita António , Metwally Osama , Meybeck Agnès , Meyer Dan , Meynert Alison M. , Meysonnier Vanina , Meziane Amina , Mezidi Mehdi , Michelanglei Céline , Michelet Isabelle , Mihnovit Vladislav , Moin Asma , Molina David , Molinos Elena , Molloy Brenda , Mone Mary , Monteiro Agostinho , Montes Claudia , Montrucchio Giorgia , Moore Sarah , Moore Shona C. , Cely Lina Morales , Moro Lucia , Motherway Catherine , Motos Ana , Mouquet Hugo , Perrot Clara Mouton , Moyet Julien , Mufti Aisha Kalsoom , Mullaert Jimmy , Müller Fredrik , Müller Karl Erik , Munblit Daniel , Muneeb Syed , Munir Nadeem , Murphy Aisling , Murphy Aisling , Murphy Lorna , Murris Marlène , Musaab Himed , Muvindi Himasha , Myrodia Dimitra Melia , Mohd-Hanafiah Farah Nadia , Nagpal Dave , Nagrebetsky Alex , Narayanan Nageswaran , Khan Rashid Nasim , Nazerali-Maitland Alasdair , Neant Nadège , Nekliudov Nikita , Neto Raul , Neumann Emily , Ng Pauline Yeung , Nghi Anthony , Nguyen Duc , Choileain Orna Ni , Leathlobhair Niamh Ni , Nitayavardhana Prompak , Nonas Stephanie , Noret Marion , Norman Lisa , Notari Alessandra , Noursadeghi Mahdad , Nowinski Adam , Nseir Saad , Nunez Jose I. , Nurnaningsih Nurnaningsih , Nyamankolly Elsa , Brien Fionnuala O. , Callaghan Annmarie O. , O’Callaghan Annmarie , Occhipinti Giovanna , OConnor Derbrenn , O’Donnell Max , Ogston Tawnya , Ogura Takayuki , O’Halloran Sophie , O’Hearn Katie , Oliveira João , Oliveira Larissa , Ong David S. Y. , Oosthuyzen Wilna , Opavsky Anne , Openshaw Peter , Orakzai Saijad , Orozco-Chamorro Claudia Milena , Ortoleva Jamel , Osatnik Javier , O’Shea Linda , O’Sullivan Miriam , Ouamara Nadia , Ouissa Rachida , Oziol Eric , Pagadoy Maïder , Pages Justine , Palacios Amanda , Palacios Mario , Palmarini Massimo , Panarello Giovanna , Paneru Hem , Panigada Mauro , Pansu Nathalie , Papadopoulos Aurélie , Parke Rachael , Parker Melissa , Parra Briseida , Pasha Taha , Pasquier Jérémie , Pastene Bruno , Patauner Fabian , Patrão Luís , Patricio Patricia , Patrier Juliette , Patterson Lisa , Pattnaik Rajyabardhan , Paul Christelle , Paul Mical , Paulos Jorge , Paxton William A. , Payen Jean-François , Peelman Florent , Peiffer-Smadja Nathan , Peigne Vincent , Pejkovska Mare , Pelosi Paolo , Peltan Ithan D. , Pereira Rui , Perez Daniel , Periel Luis , Perpoint Thomas , Pesenti Antonio , Pestre Vincent , Petrou Lenka , Petrovic Michele , Petrov-Sanchez Ventzislava , Pettersen Frank Olav , Peytavin Gilles , Pharand Scott , Picard Walter , Picone Olivier , Pierobon Carola , Piersma Djura , Pimentel Carlos , Pinto Raquel , Pires Catarina , Pironneau Isabelle , Piroth Lionel , Pius Riinu , Plantier Laurent , Poissy Julien , Pokeerbux Ryadh , Poli Sergio , Pollakis Georgios , Ponscarme Diane , Post Andra-Maris , Postma Douwe F. , Povoa Pedro , Póvoas Diana , Powis Jeff , Prapa Sofia , Preau Sébastien , Prebensen Christian , Preiser Jean-Charles , Prinssen Anton , Pritchard Mark G. , Priyadarshani Gamage Dona Dilanthi , Proença Lucia , Pudota Sravya , Puéchal Oriane , Semedi Bambang Pujo , Pulicken Mathew , Purcell Gregory , Quesada Luisa , Quinones-Cardona Vilmaris , González Víctor Quirós , Quist-Paulsen Else , Quraishi Mohammed , Rabaud Christian , Rabindrarajan Ebenezer , Rafael Aldo , Rafiq Marie , Rahutullah Arsalan , Rainieri Fernando , Ramachandran Pratheema , Ramakrishnan Nagarajan , Ramalho José , Rammaert Blandine , Ramos Grazielle Viana , Rana Asim , Rangappa Rajavardhan , Ranjan Ritika , Rapp Christophe , Rashan Aasiyah , Rashan Thalha , Rasheed Ghulam , Rasmin Menaldi , Rätsep Indrek , Rau Cornelius , Raza Ali , Real Andre , Rebaudet Stanislas , Redl Sarah , Reeve Brenda , Rehman Attaur , Reid Liadain , Reid Liadain , Reikvam Dag Henrik , Reis Renato , Remppis Jonathan , Remy Martine , Ren Hongru , Renk Hanna , Resseguier Anne-Sophie , Revest Matthieu , Rewa Oleksa , Reyes Tiago , Ribeiro Maria Ines , Richardson David , Richardson Denise , Richier Laurent , Riera Jordi , Rios Ana L. , Rishu Asgar , Rispal Patrick , Risso Karine , Rizer Nicholas , Robba Chiara , Roberto André , Roberts Stephanie , Robertson David L. , Robineau Olivier , Roche-Campo Ferran , Rodari Paola , Rodeia Simão , Abreu Julia Rodriguez , Roessler Bernhard , Roger Pierre-Marie , Rojek Amanda , Romaru Juliette , Roncon-Albuquerque Roberto , Roriz Mélanie , Rosa-Calatrava Manuel , Rose Michael , Rosenberger Dorothea , Rossanese Andrea , Rossetti Matteo , Rossignol Bénédicte , Rossignol Patrick , Rousset Stella , Roy Carine , Roze Benoît , Rusmawatiningtyas Desy , Russell Clark D. , Ryan Maeve , Ryan Maria , Ryckaert Steffi , Holten Aleksander Rygh , Saba Isabela , Sadaf Sairah , Sadat Musharaf , Sahraei Valla , Saidani Nadia , Saint-Gilles Maximilien , Sakiyalak Pranya , Salahuddin Nawal , Salazar Leonardo , Saleem Jodat , Sales Gabriele , Sallaberry Stéphane , Gandonniere Charlotte Salmon , Salvator Hélène , Sanchez Olivier , Sanchez-Miralles Angel , Sancho-Shimizu Vanessa , Sandhu Gyan , Sandhu Zulfiqar , Sandrine Pierre-François , Sandulescu Oana , Santos Marlene , Sarfo-Mensah Shirley , Banheiro Bruno Sarmento , Sarton Benjamine , Satyapriya Sree , Satyawati Rumaisah , Saviciute Egle , Schaffer Justin , Schermer Tjard , Scherpereel Arnaud , Schneider Marion , Schroll Stephan , Schwameis Michael , Scott Janet T. , Scott-Brown James , Sedillot Nicholas , Seitz Tamara , Selvanayagam Jaganathan , Semaille Caroline , Semple Malcolm G. , Senneville Eric , Sequeira Filipa , Sequeira Tânia , Neto Ary Serpa , Balazote Pablo Serrano , Shadowitz Ellen , Shamsah Mohammad , Sharjeel Shaikh , Sharma Pratima , Shaw Catherine A. , Shaw Victoria , Sheharyar Ashraf , Shetty Rajesh Mohan , Shi Haixia , Shiekh Mohiuddin , Shimizu Keiki , Shrapnel Sally , Shrestha Shubha Kalyan , Shrestha Pramesh Sundar , Shum Hoi Ping , Mohammed Nassima Si , Sibiude Jeanne , Siddiqui Atif , Sigfrid Louise , Sillaots Piret , Silva Catarina , Silva Maria Joao , Silva Rogério , Sin Wai Ching , Singh Budha Charan , Singh Punam , Sitompul Pompini Agustina , Skogen Vegard , Smith Sue , Smood Benjamin , Smyth Coilin , Smyth Michelle , Smyth Michelle , Snacken Morgane , So Dominic , Solomon Joshua , Solomon Tom , Somers Emily , Sommet Agnès , Song Myung Jin , Song Rima , Song Tae , Chia Jack Song , Sotto Albert , Soum Edouard , Sousa Ana Chora , Sousa Marta , Uva Maria Sousa , Sperry Alexandra , Spinuzza Elisabetta , Darshana B. P. Sanka Ruwan Sri , Sriskandan Shiranee , Stabler Sarah , Staudinger Thomas , Stecher Stephanie-Susanne , Stienstra Ymkje , Stiksrud Birgitte , Stolz Eva , Stone Amy , Streinu-Cercel Adrian , Streinu-Cercel Anca , Stuart Ami , Stuart David , Suen Gabriel , Suen Jacky Y. , Sultana Asfia , Summers Charlotte , Supic Dubravka , Surovcová Magdalena , Svistunov Andrey , Syrigos Konstantinos , Sztajnbok Jaques , Szuldrzynski Konstanty , Tabrizi Shirin , Tagherset Lysa , Taleb Sara , Talsma Jelmer , Tampubolon Maria Lawrensia , Tanaka Hiroyuki , Taqdees Huda , Taqi Arshad , Tardivon Coralie , Tattevin Pierre , Taufik M. Azhari , Tawfik Hassan , Tedder Richard S. , Teixeira João , Tejada Sofia , Tellier Marie-Capucine , Téoulé François , Terpstra Pleun , Terrier Olivier , Terzi Nicolas , Tessier-Grenier Hubert , Tey Adrian , Thakur Anand , Thibault Vincent , Thiberville Simon-Djamel , Thill Benoît , Thompson Shaun , Thomson Emma C. , Thwaites Ryan S. , Tierney Paul , Tieroshyn Vadim , Timashev Peter S. , Timsit Jean-François , Vijayaraghavan Bharath Kumar Tirupakuzhi , Tissot Noémie , Toki Maria , Tonby Kristian , Torre Marta , Torres Antoni , Torres Margarida , Torres-Zevallos Hernando , Towers Michael , Trapani Tony , Treoux Théo , Tromeur Cécile , Trontzas Ioannis , Trouillon Tiffany , Truong Jeanne , Tual Christelle , Tubiana Sarah , Tuite Helen , Turmel Jean-Marie , Turtle Lance C. W. , Twardowski Pawel , Uchiyama Makoto , Udayanga P. G. Ishara , Udy Andrew , Ullrich Roman , Uribe Alberto , Usman Asad , Uyeki Timothy M. , Vajdovics Cristinava , Val-Flores Luís , Valran Amélie , Van de Velde Stijn , van den Berge Marcel , van der Palen Job , van der Valk Paul , Van Der Vekens Nicky , Van der Voort Peter , Van Der Werf Sylvie , van Gulik Laura , Van Hattem Jarne , van Netten Carolien , van Veen Ilonka , Vanel Noémie , Vanoverschelde Henk , Varghese Pooja , Vauchy Charline , Veislinger Aurélie , Vencken Sebastian , Ventura Sara , Verbon Annelies , Vickers James , Vidal José Ernesto , Vieira César , Vijayan Deepak , Villanueva Joy Ann , Villar Judit , Villeneuve Pierre-Marc , Villoldo Andrea , Visseaux Benoit , Visser Hannah , Vitiello Chiara , Vonkeman Harald , Vuotto Fanny , Shukeri Wan Fadzlina Wan Muhd , Wang Chih-Hsien , Webb Steve , Wei Jia , Weil Katharina , Wesselius Sanne , West T. Eoin , Wham Murray , Whelan Bryan , White Nicole , Wicky Paul Henri , Wiedemann Aurélie , Wijaya Surya Otto , Wille Keith , Willems Suzette , Williams Virginie , Wils Evert-Jan , Yiu Ng Wing , Wong Calvin , Xynogalas Ioannis , Yamazaki Masaki , Yazdanpanah Yazdan , Yelnik Cécile , Yerkovich Stephanie , Yokoyama Toshiki , Yonis Hodane , Yousif Obada , Yuliarto Saptadi , Zaaqoq Akram , Zabbe Marion , Zahran Maram , Zambon Maria , Zanella Alberto , Zayyad Hiba , Zoufaly Alexander , Zucman David 
Published: September 2022

Background

Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs).

Methods

This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support.

Results

A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]).

Conclusions

In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality.

Trial registrationThis is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable.