{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:10:46Z","timestamp":1789470646213,"version":"build-2803163510"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Science and Technology Planning Project"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Coronavirus disease 2019 (COVID-19) has spread globally, and many patients with severe cases have received oxygen therapy through a high-flow nasal cannula (HFNC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We assessed the efficacy of HFNC for treating patients with COVID-19 and risk factors for HFNC failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, and the Cochrane Central Register of randomized controlled trials (RCTs) and observational studies of HFNC in patients with COVID-19 published in English from January 1st, 2020 to August 15th, 2021. The primary aim was to assess intubation, mortality, and failure rates in COVID-19 patients supported by HFNC. Secondary aims were to compare HFNC success and failure groups and to describe the risk factors for HFNC failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 25 studies fulfilled selection criteria and included 2851 patients. The intubation, mortality, and failure rates were 0.44 (95% confidence interval (CI): 0.38\u20130.51, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200984%), 0.23 (95% CI: 0.19\u20130.29, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200988%), and 0.47 (95% CI: 0.42\u20130.51, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200956%), respectively. Compared to the success group, age, body mass index (BMI), Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, D-dimer, lactate, heart rate, and respiratory rate were higher and PaO\n                      <jats:sub>2<\/jats:sub>\n                      , PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      , ROX index (the ratio of SpO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      to respiratory rate), ROX index after the initiation of HFNC, and duration of HFNC were lower in the failure group (all Ps\u2009&lt;\u20090.05). There were also more smokers and more comorbidities in the failure group (all Ps\u2009&lt;\u20090.05). Pooled odds ratios (ORs) revealed that older age (OR: 1.04, 95% CI: 1.01\u20131.07, P\u2009=\u20090.02, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200988%), a higher white blood cell (WBC) count (OR: 1.06, 95% CI: 1.01\u20131.12, P\u2009=\u20090.02, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), a higher heart rate (OR: 1.42, 95% CI: 1.15\u20131.76, P\u2009&lt;\u20090.01, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), and a lower ROX index(OR: 0.61, 95% CI: 0.39\u20130.95, P\u2009=\u20090.03, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200993%) after the initiation of HFNC were all significant risk factors for HFNC failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>HFNC is an effective way of providing respiratory support in the treatment of COVID-19 patients. Older age, a higher WBC count, a higher heart rate, and a lower ROX index after the initiation of HFNC are associated with an increased risk of HFNC failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666221091931","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T09:35:07Z","timestamp":1650879307000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Effectiveness of the use of a high-flow nasal cannula to treat COVID-19 patients and risk factors for failure: a meta-analysis"],"prefix":"10.1177","volume":"16","author":[{"given":"Dong-yang","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, 110001 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-4168","authenticated-orcid":false,"given":"Wei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-wen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, 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