Three years later, we know a little more about how to treat COVID-19.

The Covid-19 pandemic has wreaked havoc around the world, claiming almost 7 million lives. In America, the number of deaths is approaching 3 million, while in Spain the number is around 120,000 deaths.

Since the beginning of the pandemic, health care systems in many countries have been under enormous pressure due to the large number of people who need treatment for complications of the disease. All this time, medical and scientific personnel have been working tirelessly to find effective and safe treatments.

beat choke

One of the most common complications of COVID-19 is acute respiratory failure, also known as severe acute respiratory distress syndrome (SARDS). This syndrome includes extremely labored breathing, which can lead patients to suffocate.

In severe cases, the only solution is to insert a tube through the airway to supply oxygen. But this is an invasive procedure that requires sedation and can have serious side effects, including infections and potential damage to the throat and lungs. In addition, these intubations are performed in intensive care units (ICUs), which can be overcrowded.

For all of these reasons, before proceeding with intubation, medical personnel try to relieve breathing by resorting to less aggressive methods or non-invasive methods of treatment. Risky: Delaying intubation can be counterproductive and even endanger the patient’s life.

compressed air for breathing

The solution to this dilemma came from the hands of science. On the one hand, from a non-invasive respiratory therapy technique called continuous positive airway pressure (CPAP). It simply consists of putting on a mask that inflates pressurized air. This method helps to keep the airway open by gently forcing air into the patient’s lungs.

But there is another method, which is to use a high flow nasal cannula (HFNC, an abbreviation in English). This is a nasal tube that delivers air with high flow and moisture, providing a constant amount of air and oxygen.

Researchers at the Zendal Nursing Hospital in Madrid, in collaboration with the University of Castile-La Mancha, studied how the combination of these two non-invasive treatments works for COVID-19 patients suffering from acute respiratory distress syndrome. Can you improve the patient’s response enough to prevent deterioration and possible intubation?

Everything must be scientifically proven

To get an answer, the researchers divided a total of 760 patients into two groups. On one side were those who received combination therapy (HFNC + CPAP) within the first 24 hours of admission to the Respiratory Intensive Care Unit (UCRI). On the other hand, those who received the same treatment, but after this period of time had passed.

The results of the study were encouraging. Patients who received combined treatment in the first 24 hours after admission to the intensive care unit, the need for intubation decreased. In addition, 30-day mortality was significantly lower in the group receiving combined treatment up to 24 hours compared to the other group (8.2% vs. 15.5%, respectively). As for the frequency of intubation, it was significantly lower in the first group (34.5%) than in the second (41.8%).

This means that if this combination of treatments is implemented early, it could save the lives of many COVID-19 patients who develop this acute respiratory syndrome.

In addition, this strategy is non-invasive, patients do not need to be intubated. This can reduce the risk of complications and the need for additional hospital resources.

covid-19 is not over

The significance of this study is enormous. If it had been published earlier, many lives would certainly have been saved, but science needs its time.

However, it is not too late. In the post-pandemic era, even though most people are vaccinated, there is still a percentage of the population that can develop covid-19 and require hospitalization.

Although this study was conducted in a single Spanish hospital (and therefore more research is needed to confirm these results), the results are encouraging. We have early evidence that the combination of these two non-invasive respiratory therapies, especially up to 24 hours after admission, may make a big difference in mortality and the need for intubation in critically ill patients with COVID-19.

In addition, since hospital resources are limited, this strategy can be particularly useful in areas where health systems may once again be overwhelmed.

Not forgetting that the use of this therapy can help with other diseases that also lead to severe acute respiratory distress syndrome (ARDS).

Alberto Najera Lopez, professor of radiology and physical medicine at the Albacete Medical School. Scientific Culture and Innovation Department Coordinator (UCLMdivulga), University of Castile-La Mancha; Jesús González Rubio, Associate Professor of Biostatistics, University of Castile-La Mancha; Jose Teran, Health Service of Castile-La Mancha; Juan de Dios Navarro Lopez, professor of physiology, University of Castile-La Mancha; Lydia Jimenez Diaz, professor of physiology, University of Castile-La Mancha and Pedro Landete, Autonomous University of Madrid

This article was originally published on The Conversation. Read the original.