TY - JOUR T1 - Outcomes of patients with COVID-19 pneumonia treated with CPAP JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2021.PA1079 VL - 58 IS - suppl 65 SP - PA1079 AU - Roberta Di Tria AU - Giovanni Ferrari AU - Paolo Righini AU - Alessia Marchisio AU - Chiara Caponnetto AU - Valter Gallo AU - Sonia Bassini AU - Roberto Prota Y1 - 2021/09/05 UR - http://erj.ersjournals.com/content/58/suppl_65/PA1079.abstract N2 - Background: In patients with acute respiratory failure due to COVID-19 pneumonia, continuous positive airway pressure (CPAP) may be a valuable approach.Aim: Evaluate outcomes of patients with COVID-19 pneumonia treated with CPAP: endotracheal intubation (ETI), improvement in gas exchange, length of stay (LOS), mortality.Methods: Monocentric, retrospective, observational study. 148 patients enrolled (March 14 – May 15 2020), all treated with CPAP in Respiratory Care Unit (RCU). Criteria for enrolment: PaO2/FiO2 (P/F) <300, respiratory rate >24 ± respiratory distress. Lung ultrasound score (LUS) at time of RCU admission was assessed.Results: Median age was 72.5 years; 99 patients were male, 37 underwent ETI, 40 died. Patients who underwent ETI had a higher risk of death (2.08 - 95%CI 1.23–3.53; p=0.008). P/F at RCU admission wasn’t different between who underwent ETI and who overcame successfully CPAP (160 vs 170; p=0.35), while a significant difference was observed at 1 and 48 hours (P/F 155 vs 220 p<0.0001 and 154 vs 239 p=0.001 respectively). No improvement in P/F after 1 hour of CPAP was associated with an increased risk of ETI (RR 2.57 - 95%CI 1.47–4.47; p<0.0001) and death (RR 3.26 - 95%CI 1.89–5.61; p<0.0001). No difference was observed in hospital LOS (26 vs 19 days respectively; p=0.09). A LUS score >18 at RCU admission was associated with an increased mortality rate (p=0.04). Age >72 years was associated with an increased risk of death (RR 4.37 - 95%CI 1.95–9.80; p<0.001).Conclusions: Early improvement in gas exchange may identify patients who can undergo successfully CPAP treatment. Variables associated with CPAP failure, that should encourage early intubation, are a severe LUS at admission and age >72 years.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1079.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.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 -