30-DAY AND 90-DAY OUTCOMES OF THE SURVIVORS OF COVID-19 PNEUMONIA TREATED EXCLUSIVELY WITH CPAP: RESULTS FROM A DISTRICT TEACHING HOSPITAL

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: The recent two waves of the pandemic have caused over 127,000 deaths in the UK, with over 4.4 million cases and estimated global mortality of approximately 3 million when writing this abstract. Patients hospitalised with COVID-19 pneumonia have severe hypoxic respiratory failure, and it can be challenging to maintain adequate oxygenation with traditional oxygen supplementation. Continuous Positive Airway Pressure (CPAP) was used to avoid mechanical ventilation and rationalise oxygen stocks. CPAP is beneficial in studies globally. We studied the outcomes of the survivors of COVID 19 pneumonia treated exclusively with CPAP who belonged to the Not for ICU group, admitted exclusively to the ward-based CPAP unit. METHODS: Retrospective data were collected on the survivors of patients admitted to a ward-based CPAP in Suspected or confirmed COVID-19 with pneumonitis and type 1 Respiratory failure. Patients admitted for BIPAP were excluded. Patients on CPAP for OSA or Obesity Hypoventilation syndrome who required being in the unit for infection control purposes were also excluded. Data collected on basic demographics and specific information like comorbidities, status length of stay, CPAP duration, discharge prescription of oxygen were collected and analysed. RESULTS: 28 patients were identified who received CPAP only during both the first and second wave (March to July 2021 and January to March 2021) of the pandemic. 17 Males and 11 females, 60% and 40% respectively, received CPAP only—the average age was 63.5 years, range 37 to 86 years. Twenty-six out of survivors of CPAP only treatment group 28 are alive, at 30 days 60 days and 26 were alive at 90 days. The mean length of stay of this cohort was 23 days due to rehabilitation requirements. Further, twenty-seven out of twenty-eight patients (96% ) were COVID PCR positive, and one patient was COVID PCR negative but radiology consistent with COVID pneumonitis. Nine patients (31.2%) were discharged on home oxygen;4 of them had a respiratory morbidity -2 patients with ILD, two patients with COPD. At 90 days, 4 of these nine patients discharged on home oxygen were still on oxygen Duration CPAP ranged from and 3 to 14 days with an average of 6.33 days. Two patients were on CPAP at discharge due to a new diagnosis of Obesity hypoventilation /OSA, and 5 of them were on CPAP for OSA at admission. The most common comorbidities among this cohort were Hypertension 9/28, Diabetes mellitus 7/28, Asthma 4/28 and COPD 3 /28 patients CONCLUSIONS: Patients treated who received exclusive ward-based CPAP due to being not for ICU level of care had a good 60-day 90-day survival. Up to a third (31.2%) were still requiring oxygen at the time of discharge, indicating a prolonged recovery phase of the respiratory failure.15% still on oxygen at 90 days. CLINICAL IMPLICATIONS: CPAP for COVID pneumonia has favourable outcome even at 60 and 90 days post CPAP, with a third of patients requiring oxygen at discharge. DISCLOSURES: No relevant relationships by Wee Teck Lim, source=Web Response No relevant relationships by Farah Asyikin Mohamad Nasir, source=Web Response No relevant relationships by Ernest Okpo, source=Web Response No relevant relationships by Aravind Ponnuswamy, source=Web Response No relevant relationships by Tariq Trussell, source=Web Response