Evidence map›Paper›PMID 35956070›Full record

ArticleJournal of clinical medicine2022

Continuous Positive Airway Pressure in Elderly Patients with Severe COVID-19 Related Respiratory Failure.

Elisa Ceriani, Annalisa Pitino, Dejan Radovanovic, Emanuele Salvi, Maddalena Matone, Thomas Teatini, Antonio Gidaro, Giovanni Tripepi, Pierachille Santus, Mercedes Gori and 1 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Elisa CerianiDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.
Annalisa PitinoInstitute of Clinical Physiology (IFC-CNR), Section of Rome, 00185 Rome, Italy.
Dejan RadovanovicDepartment of Pneumology, L. Sacco Hospital, Università Degli Studi di Milano, 20157 Milano, Italy.ORCID 0000-0002-9013-3418
Emanuele SalviDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.ORCID 0000-0001-9849-4798
Maddalena MatoneDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.
Thomas TeatiniDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.
Antonio GidaroDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.ORCID 0000-0002-5379-1091
Giovanni TripepiInstitute of Clinical Physiology (IFC-CNR), Section of Reggio Calabria, 89124 Reggio Calabria, Italy.
Pierachille SantusDepartment of Pneumology, L. Sacco Hospital, Università Degli Studi di Milano, 20157 Milano, Italy.ORCID 0000-0003-3462-8253
Mercedes GoriInstitute of Clinical Physiology (IFC-CNR), Section of Rome, 00185 Rome, Italy.
Chiara CogliatiDepartment of Internal Medicine, L. Sacco Hospital, Università Degli Studi di Milano, Via GB Grassi, 20157 Milano, Italy.
Luigi Sacco Hospital · ITIstituto di Fisiologia Clinica · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The elderly population represents a high percentage of patients hospitalized for COVID-19 pneumonia and severe respiratory failure, for whom CPAP may be a treatment option. The aim of this study was to describe the CPAP support modalities and to explore factors associated with CPAP failure. In this retrospective study, 110 consecutive patients aged ≥ 75 years were enrolled. Median frailty score, baseline partial arterial pressure of oxygen to fraction of inspired oxygen ratio (P/F), and respiratory rate (RR) were 5, 108, and 30 cycles/min, respectively. Of the 110 patients that began CPAP treatment, 17 patients died within 72 h from baseline, while in 2 patients, CPAP was withdrawn for clinical improvement. Thus, of the 91 patients still on CPAP at day 3, 67% of them needed continuous CPAP delivery. Patients with RR ≥ 30 and with frailty score ≥ 5 had an odds ratio of continuous CPAP needing of 3 and 4, respectively. Patients unable to tolerate CPAP-free periods demonstrated higher mortality risk as compared to those able to tolerate intermittent CPAP (OR: 6.04, 95% CI 2.38−16.46, p < 0.001). The overall in-hospital mortality was 63.6%. Delirium occurred in 59.1%, with a mortality rate in this subgroup of 83.1%. In a time-varying Cox model, the hazard ratio of death was 2.9 in patients with baseline RR ≥ 30 cycle/min, 2.4 in those with baseline P/F < 100. In the same model, the hazard ratio of death was 20 in patients with delirium and a frailty score < 5 and 8.8 in those without delirium and with frailty ≥ 5, indicating a competitive effect between these two variables on the death risk. Conclusions: Respiratory impairment, frailty, and delirium predict treatment failure, with the latter two factors demonstrating a competitive effect on mortality risk. CPAP support may represent a feasible therapeutic option in elderly patients, although chances of a therapeutic benefit are markedly reduced in case of severe respiratory impairment, very frail baseline condition or delirium occurrence.

Indexed as

continuous positive airway pressureCOVID-19CPAPelderlyventilation

Identifiers

PMID35956070
PMCPMC9369612
OpenAlexW4289175418

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.