%0 Journal Article %A Maulin Patel %A Andrew Gangemi %A Robert Marron %A Junad Chowdhury %A Ibraheem Yousef %A Matthew Zheng %A Nicole Mills %A Lauren Tragesser %A Julie Giurintano %A Rohit Gupta %A Matthew Gordon %A Parth Rali %A Gilbert D'Alonso %A David Fleece %A Huaqing Zhao %A Nicole Patlakh %A Gerard Criner %T Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure %D 2020 %R 10.1136/bmjresp-2020-000650 %J BMJ Open Respiratory Research %P e000650 %V 7 %N 1 %X Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group.Conclusion HFNT use is associated with a reduction in the rate of invasive mechanical ventilation and overall mortality in patients with COVID-19 infection. %U https://bmjopenrespres.bmj.com/content/bmjresp/7/1/e000650.full.pdf