Observational studyCritical care (London, England)2022
Early intubation and decreased in-hospital mortality in patients with coronavirus disease 2019.
Observational study in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Observational studies of early versus late salvage therapies in critical care exhibit intrinsic selection bias: two meta-analyses.Critical care (London, England) · 2025Pooled it
- Timing of intubation and ICU mortality in COVID-19 patients: a retrospective analysis of 4198 critically ill patients during the first and second waves.BMC anesthesiology · 2023Trial
- Impact of Endotracheal Intubation Timing on Clinical Outcomes in Patients with Severe Pneumonia: A Single-Center Retrospective Cohort Study.Infection and drug resistance · 2026Article
- Ventilator-Associated Lung Injury: Pathophysiology, Prevention, and Emerging Therapeutic Strategies.International journal of molecular sciences · 2025Review
- New scoring system combining WHO ordinal scale and MASCC score in predicting mortality of COVID-19 patients with malignancy and neutropenia: a retrospective cohort study.BMC infectious diseases · 2025Article
- Factors associated with the intubation of patients with acute respiratory failure and their impact on mortality: a retrospective cohort study.BMC pulmonary medicine · 2025Article
- High-Flow Nasal Cannula Application After Extubation in Acute Respiratory Failure Patients.Journal of clinical medicine · 2025Article
- Use of a gas-operated ventilator as a noninvasive bridging respiratory therapy in critically Ill COVID-19 patients in a middle-income country.Internal and emergency medicine · 2025Article
- The Respiratory Mechanics of COVID-19 Acute Respiratory Distress Syndrome-Lessons Learned?Journal of clinical medicine · 2024Review
- Barotrauma in patients with severe coronavirus disease 2019-retrospective observational study.Journal of thoracic disease · 2023Article
- Early symptoms preceding post-infectious irritable bowel syndrome following COVID-19: a retrospective observational study incorporating daily gastrointestinal symptoms.BMC gastroenterology · 2023Observational
- Timing of Intubation in COVID-19: When It Is Too Early and When It Is Too Late.Critical care explorations · 2023Article
- Timing of invasive mechanical ventilation and death in critically ill adults with COVID-19: A multicenter cohort study.PloS one · 2023Article
- What did we learn about tocilizumab use against COVID-19? A single-center observational study from an intensive care unit in Serbia.Frontiers in medicine · 2023Article
- The COVID-19 pandemic: a gateway between one world and the next!Anaesthesia, critical care & pain medicine · 2022Article
Corrections and comments
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSome academic organizations recommended that physicians intubate patients with COVID-19 with a relatively lower threshold of oxygen usage particularly in the early phase of pandemic. We aimed to elucidate whether early intubation is associated with decreased in-hospital mortality among patients with novel coronavirus disease 2019 (COVID-19) who required intubation.
methodsA multicenter, retrospective, observational study was conducted at 66 hospitals in Japan where patients with moderate-to-severe COVID-19 were treated between January and September 2020. Patients who were diagnosed as COVID-19 with a positive reverse-transcription polymerase chain reaction test and intubated during admission were included. Early intubation was defined as intubation conducted in the setting of ≤ 6 L/min of oxygen usage. In-hospital mortality was compared between patients with early and non-early intubation. Inverse probability weighting analyses with propensity scores were performed to adjust patient demographics, comorbidities, hemodynamic status on admission and time at intubation, medications before intubation, severity of COVID-19, and institution characteristics. Subgroup analyses were conducted on the basis of age, severity of hypoxemia at intubation, and days from admission to intubation.
resultsAmong 412 patients eligible for the study, 110 underwent early intubation. In-hospital mortality was lower in patients with early intubation than those with non-early intubation (18 [16.4%] vs. 88 [29.1%]; odds ratio, 0.48 [95% confidence interval 0.27-0.84]; p = 0.009, and adjusted odds ratio, 0.28 [95% confidence interval 0.19-0.42]; p < 0.001). The beneficial effects of early intubation were observed regardless of age and severity of hypoxemia at time of intubation; however, early intubation was associated with lower in-hospital mortality only among patients who were intubated later than 2 days after admission.
conclusionsEarly intubation in the setting of ≤ 6 L/min of oxygen usage was associated with decreased in-hospital mortality among patients with COVID-19 who required intubation. Trial Registration None.
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