High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis

<p>Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, which was first discovered in Wuhan, China. The disease has grown into a global pandemic causing mild to moderate symptoms in most people. The disease can also exhibit serious illnesses, especially for patien...

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Main Author: Nabil Shallik (15900256) (author)
Other Authors: Khalid Bashir (9300293) (author), Amr Elmoheen (16404882) (author), Haris Iftikhar (15954223) (author), Hany A. Zaki (17337673) (author)
Published: 2023
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_version_ 1864513528418795520
author Nabil Shallik (15900256)
author2 Khalid Bashir (9300293)
Amr Elmoheen (16404882)
Haris Iftikhar (15954223)
Hany A. Zaki (17337673)
author2_role author
author
author
author
author_facet Nabil Shallik (15900256)
Khalid Bashir (9300293)
Amr Elmoheen (16404882)
Haris Iftikhar (15954223)
Hany A. Zaki (17337673)
author_role author
dc.creator.none.fl_str_mv Nabil Shallik (15900256)
Khalid Bashir (9300293)
Amr Elmoheen (16404882)
Haris Iftikhar (15954223)
Hany A. Zaki (17337673)
dc.date.none.fl_str_mv 2023-06-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.tacc.2023.101238
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/High_flow_nasal_oxygen_HFNO_in_the_treatment_of_COVID-19_infection_of_adult_patients_from_An_emergency_perspective_A_systematic_review_and_meta-analysis/25117091
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
High Flow Nasal Oxygen (HFN)
COVID-19
Emergency Perspective
Non-invasive ventilation (NIV)
positive airway pressure (CPAP)
dc.title.none.fl_str_mv High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p>Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, which was first discovered in Wuhan, China. The disease has grown into a global pandemic causing mild to moderate symptoms in most people. The disease can also exhibit serious illnesses, especially for patients with other chronic diseases such as cardiovascular diseases, diabetes, chronic respiratory disease, or cancer. In such cases of severe illness, high flow nasal oxygen (HFNO) has been used to provide oxygenation to COVID-19 patients. However, the efficiency of HFNO remains uncertain, prompting the conduction of this systematic review to evaluate the effectiveness of the therapy. A thorough search for relevant and original articles was carried out on five electronic databases, including ScienceDirect, PubMed, Cochrane Library, Embase, and Google Scholar. No time limitation was placed during the search as it included all the articles related to COVID-19 from 2019 to 2022. The search strategy utilized in this systematic review yielded 504 articles, of which only 10 met the eligibility criteria and were included. Our meta-analysis reveals that HFNO success rate was higher than HFNO failure rates (0.52 (95% CI; 0.47, 0.56) and 0.48 (95% CI; 0.44, 0.53), respectively), however, the difference was statistically insignificant. HFNO was associated with a significant decrease in mortality and intubation rates (0.28 (95% CI; 0.19, 0.39) and 0.28 (95% CI; 0.18, 0.41), respectively). Our statistical analysis has shown that significantly lower ROX index (5.07 ± 1.66, p = 0.028) and PaO2/FiO2 (100 ± 27.51, p = 0.031) are associated with HFNO failure, while a significantly lower respiratory rate (RR) (23.17 ± 4.167, p = 0.006) is associated with HFNO success. No statistically significant difference was observed in SpO2/FiO2 ratio between the HFNO success and failure groups (154.23 ± 42.74 vs. 124.025 ± 28.50, p = 0.62, respectively). Based on the results from our meta-analysis, the success or failure of HFNO in treating COVID-19 adult patients remains uncertain. However, HFNO has been shown to be an effective treatment in reducing mortality and intubation rates. Therefore, HFNO can be recommended for COVID-19 patients but with close monitoring and should be carried out by experienced healthcare workers.</p><h2>Other Information</h2> <p> Published in: Trends in Anaesthesia and Critical Care<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.tacc.2023.101238" target="_blank">https://dx.doi.org/10.1016/j.tacc.2023.101238</a></p>
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identifier_str_mv 10.1016/j.tacc.2023.101238
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/25117091
publishDate 2023
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spelling High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysisNabil Shallik (15900256)Khalid Bashir (9300293)Amr Elmoheen (16404882)Haris Iftikhar (15954223)Hany A. Zaki (17337673)Biomedical and clinical sciencesClinical sciencesHigh Flow Nasal Oxygen (HFN)COVID-19Emergency PerspectiveNon-invasive ventilation (NIV)positive airway pressure (CPAP)<p>Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, which was first discovered in Wuhan, China. The disease has grown into a global pandemic causing mild to moderate symptoms in most people. The disease can also exhibit serious illnesses, especially for patients with other chronic diseases such as cardiovascular diseases, diabetes, chronic respiratory disease, or cancer. In such cases of severe illness, high flow nasal oxygen (HFNO) has been used to provide oxygenation to COVID-19 patients. However, the efficiency of HFNO remains uncertain, prompting the conduction of this systematic review to evaluate the effectiveness of the therapy. A thorough search for relevant and original articles was carried out on five electronic databases, including ScienceDirect, PubMed, Cochrane Library, Embase, and Google Scholar. No time limitation was placed during the search as it included all the articles related to COVID-19 from 2019 to 2022. The search strategy utilized in this systematic review yielded 504 articles, of which only 10 met the eligibility criteria and were included. Our meta-analysis reveals that HFNO success rate was higher than HFNO failure rates (0.52 (95% CI; 0.47, 0.56) and 0.48 (95% CI; 0.44, 0.53), respectively), however, the difference was statistically insignificant. HFNO was associated with a significant decrease in mortality and intubation rates (0.28 (95% CI; 0.19, 0.39) and 0.28 (95% CI; 0.18, 0.41), respectively). Our statistical analysis has shown that significantly lower ROX index (5.07 ± 1.66, p = 0.028) and PaO2/FiO2 (100 ± 27.51, p = 0.031) are associated with HFNO failure, while a significantly lower respiratory rate (RR) (23.17 ± 4.167, p = 0.006) is associated with HFNO success. No statistically significant difference was observed in SpO2/FiO2 ratio between the HFNO success and failure groups (154.23 ± 42.74 vs. 124.025 ± 28.50, p = 0.62, respectively). Based on the results from our meta-analysis, the success or failure of HFNO in treating COVID-19 adult patients remains uncertain. However, HFNO has been shown to be an effective treatment in reducing mortality and intubation rates. Therefore, HFNO can be recommended for COVID-19 patients but with close monitoring and should be carried out by experienced healthcare workers.</p><h2>Other Information</h2> <p> Published in: Trends in Anaesthesia and Critical Care<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.tacc.2023.101238" target="_blank">https://dx.doi.org/10.1016/j.tacc.2023.101238</a></p>2023-06-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.tacc.2023.101238https://figshare.com/articles/journal_contribution/High_flow_nasal_oxygen_HFNO_in_the_treatment_of_COVID-19_infection_of_adult_patients_from_An_emergency_perspective_A_systematic_review_and_meta-analysis/25117091CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/251170912023-06-01T00:00:00Z
spellingShingle High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
Nabil Shallik (15900256)
Biomedical and clinical sciences
Clinical sciences
High Flow Nasal Oxygen (HFN)
COVID-19
Emergency Perspective
Non-invasive ventilation (NIV)
positive airway pressure (CPAP)
status_str publishedVersion
title High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
title_full High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
title_fullStr High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
title_full_unstemmed High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
title_short High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
title_sort High flow nasal oxygen (HFNO) in the treatment of COVID-19 infection of adult patients from – An emergency perspective: A systematic review and meta-analysis
topic Biomedical and clinical sciences
Clinical sciences
High Flow Nasal Oxygen (HFN)
COVID-19
Emergency Perspective
Non-invasive ventilation (NIV)
positive airway pressure (CPAP)