Juntos Ante el Peligro: Resultados de traquetomías para pacientes críticos por COVID-19, unidades multicéntricas de ORL en Castilla y León: Estudio de cohortes de más de 139 pacientes críticos COVD-19

A Cohort Study Over 139 Critical COVID-19 Patients

Abstract

Introduction and objective: The question of an optimal strategy and outcomes in COVID-19 tracheotomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheotomy on intubated COVID-19 patients.

Method: A multicentric prospective observational study of COVID-19 patients undergoing tracheotomy in 13 hospitals from Castilla y León (Spain) was conducted over 7 weeks (from March 28 to May 15, 2020). Data were collected daily with instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival.

Results: We performed 139 tracheotomies in critical COVID-19 patients : 90 surgical tracheotomies (64,8%) and 49 percutaneous tracheotomies. Median timing of tracheotomy was 12 days (4–42 days) since orotracheal intubation. A close follow-up at the cut-off time of 1-month follow-up showed that weaning was achieved in 73 patients ( 52,5%) while 51 (30,7%) were still under mechanical ventilation and 15 (10,8%) patients had died from COVID-19. Decannulation among those in whom weaning was successful was achieved in 31patients. 15 otolaryngologists testing positive for SARS-CoV-19 by RT-PCR during this 7 weeks.

Conclusions: The critical focus is the unprecedented amount of tracheotomies: 139 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up.