TY - JOUR T1 - Late Breaking Abstract - CPAP is effective in treating COVID-19 patients with Type 1 respiratory failure JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.4410 VL - 56 IS - suppl 64 SP - 4410 AU - Alguili Elsheikh AU - Vijayalakshmi Karunanithi AU - Aarani Mahalingam AU - Muhammad Shafiq AU - Niranjan Setty AU - Johnson Samuel Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/4410.abstract N2 - Introduction: COVID-19 often results in acute adult respiratory distress syndrome (ARDS) (Jin-Gen Xia et al 2020). Current guidelines support that continuous positive airway pressure (CPAP) can be used as a bridge to invasive ventilation or as a ceiling of care in patients with a high clinical frailty score (CSF).We present the results of patients treated with CPAP in the specialist respiratory wards of a large hospital in the UK.Methods: 45 patients were trialled on CPAP over a two-month period. CPAP was started when patients required more than 10L/min of oxygen to maintain saturation above 92%.Results: The mean age was 63 years and 80% were males. In 10 patients (22%), ceiling of care was CPAP only in view of CSF. The mean PaO2/FiO2 ratio was 104. Mean PEEP was 10 cms and mean FiO2 66%. Overall 42% were successfully treated with CPAP (average duration 79 hours) and discharged home. 37% deteriorated requiring invasive ventilation (average of 30 hours CPAP pre intubation). Among those who required ICU admission 20% died, 33% were discharged home and 47% continue to be treated in hospital. In those who had CPAP as ceiling of care, 90% died. Those with successful CPAP alone had an average length of hospital stay of 11 days.Discussion: CPAP was used as a first line of ventilatory support for patients who could be categorised as moderately severe ARDS by Berlin criteria. 42% patients were discharged home with a short length of stay. The outcome of patients with CPAP as ceiling of care was poor in view of significant co-morbidities. Our data suggests CPAP can be used as first line of treatment with good outcomes.Larger studies / meta analyses are indicated to delineate this further.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4410.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -