Impact of Mechanical Ventilation on Outcomes of COVID-19 Patients in Hodeidah, Yemen

Background: Severe and critical infection of coronavirus disease 2019 (COVID -19) is characterized by Acute Respiratory Distress Syndrome (ARDS). The use of ventilators (‏non-invasive and mechanical)‏, to deliver oxygen in cases of severe and critical COVID-19. Thus far, among the 10-20 % of COVID-19 patients who require treatment in an intensive care unit (ICU)‏, about 5 % of them have been placed on mechanical ventilation (MV)‏.

Objective: Therefore, the study aimed to estimate the impact of MV in management of COVID - 19 in Hodeidah, Yemen.

Methodology: This study was designed in a case series study that included 28 COVID-19 patients admitted to ICU, isolation department , Center of Tropical Medicine and Infectious Diseases (CTMID), AL Thawrah Public Hospital Authority, Hodeidah, Yemen an reference hospital. 28 critical ills cases were reported in first wave 2020. Data included demographics, advanced life support therapies, and MV variables. The MV variables included respiratory rate (RR); fraction of inspired oxygen (FiO2); M-V; Tidal volume (Ti); positive end-expiratory pressure (PEEP); inspiratory to expiratory ratio (I:E), flow rate; peak inspiratory pressure (PIP); plateau pressure; SaO2; arterial pressure of oxygen (PaO2) ; arterial pressure of carbon dioxide (PaCo2), pH, and ventilator modes that were adjusted .

Results: The results of first wave in 2020 showed 28/505 (5.54%) patients critical illness undergo to MV. Only 6/28 patients (7,14 %) were recovered where different significant was reported (X2 = 9.143; p = 0.0025) in comparing with severe cases with non-invasive namely 20/21 (95.23 %) that were that recovered. The main outcome for recovery was 31-day survival.

Conclusion: During the peak of the pandemic in Hodeidah, Yemen, critically ill patients with COVID-19 often required MV and mortality was very high for critical cases in first waves, therefore the best practices of MV in COVID -19 must be improved.