Comparison of high-flow nasal cannula and conventional oxygen therapy in treating COVID-۱۹ patients referred to the emergency department: A randomized, single-blind clinical trial

Objective: Recently, high-flow nasal cannula (HFNC) oxygen therapy has been implicated in the treatment of patients with acute respiratory failure. In this study, the effect of this treatment on COVID-۱۹ patients was investigated.Methods : This was a prospective, randomized, single-blind clinical trial on patients with COVID-۱۹ referred to the emergency department. COVID-۱۹ patients who had peripheral oxygen saturation (SpO۲) ≤۹۰% despite receiving nasal oxygen (up to ۶ L/min) were included in the study and randomized to HFNC or conventional oxygen therapy (COT). Then the patients were compared in terms of vital signs, SpO۲, need for endotracheal intubation, and need for intensive care unit admission. The sample size was calculated at ۳۵ patients in each group. Variables were compared using the chi-square test, Student’s t-test, or the Mann-Whitney U test.Results: ۸۷ patients with a mean age of ۶۵.۳±۱۴.۸ (۶۲.۱% male) were included. The two groups were similar in terms of age, sex, time interval from onset to diagnosis, and underlying diseases (hypertension, diabetes, coronary artery disease, etc.) (P<۰.۰۵). No statistically significant difference was reported between SpO۲ and PaO۲/FiO۲ vital signs at the beginning of treatment between the two groups. One hour after treatment, respiratory rate, SpO۲, and PaO۲/FiO۲ were better in the HFNC group compared to the COT group (P<۰.۰۵). Also, there was no significant difference between the two groups in terms of the need for endotracheal intubation, the need for ICU admission, and in-hospital mortality.Conclusion: Early use of HFNC oxygen therapy in patients with COVID-۱۹ can improve SpO۲, respiratory rate, and PaO۲/FiO۲ levels. Therefore, it has high clinical value.

Keywords:

Emergency Department , COVID-۱۹ , High-flow nasal cannula , Hypoxia , Oxygen therapy