• Magdalena Vera, Eduardo Kattan, Pablo Born, Elizabeth Rivas, Macarena Amthauer, Annael Nesvadba, Barbara Lara, Isabel Rao, Eduardo Espíndola, Luis Rojas, Glenn Hernández, Guillermo Bugedo, and Ricardo Castro.
• Departamento de Medicina Intensiva, Pontificia Universidad Católica de Chile, Chile.
• J Crit Care. 2021 Oct 1; 65: 164169164-169.

PurposeTo determine whether time-to-intubation was associated with higher ICU mortality in patients with COVID-19 on mechanical ventilation due to respiratory insufficiency.Materials And MethodsWe conducted an observational, prospective, single-center study of patients with confirmed SARS-CoV-2 infection hospitalized with moderate to severe ARDS, connected to mechanical ventilation in the ICU between March 17 and July 31, 2020. We examined their general and clinical characteristics. Time-to-intubation was the time from hospital admission to endotracheal intubation.ResultsWe included 183 consecutive patients; 28% were female, and median age was 62 years old. Eighty-eight patients (48%) were intubated before 48 h (early) and ninety-five (52%) after 48 h (late). Patients intubated early had similar admission PaO2/FiO2 ratio (123 vs 99; p = 0.179) but were younger (59 vs 64; p = 0.013) and had higher body mass index (30 vs 28; p = 0.006) compared to patients intubated late. Mortality was higher in patients intubated late (18% versus 43%), with admission PaO2/FiO2 ratio < 100 mmHg (OR 5.2; p = 0.011), of older age (OR 1.1; p = 0.001), and with previous use of ACE inhibitors (OR 4.8; p = 0.026).ConclusionsIn COVID-19 patients, late intubation, Pafi <100, older age, and previous ACE inhibitors use were associated with increased ICU mortality.Copyright © 2021 Elsevier Inc. All rights reserved.

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