Invasive versus non-invasive ventilation in patients with COVID-19 pneumonia: A retrospective study

Objective: To compare the survival and length of stay of invasive ventilation (IV) with those of non-invasive ventilation (NIV) in patients with COVID-19 acute respiratory distress syndrome in a single hospital from May 2020 to March 2021. Methods: After obtaining approval from the Hospital Director, the data of COVID-19 patients including demographics, type of respiratory support (non-invasive ventilation or invasive ventilation), duration of ventilation, length of stay, discharge, and death were collected and analyzed. Results: Out of the 152 patients identified, 134 patients were analyzed. The median intubation days were 10.0 (Q1: 3.5, Q3: 13.5) in the IV group and 0.0 (Q1: 0.0, Q3: 0.0) days in the NIV-only group. Out of the 101 patients who received NIV, 43 patients were subsequently intubated due to failure of NIV. Of the 63 patients (47.01%) who died, 22 (66.66%) were from the IV group and 40 (92.02%) were from the NIV-followed-by-intubation group, and 1 (1.72%) were from the NIV-only group. Multivariate analysis showed that the presence of a respiratory comorbidity (OR=16.56, 95% CI=1.56-175.48, P=0.02) was an independent predictor of survival. Conclusions: Respiratory co-morbidity is a significant adverse predictor of survival outcome. The decision on the type of respiratory support should be made on a patient-to-patient basis.