{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:17:46Z","timestamp":1771082266013,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Effective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; <jats:italic>p<\/jats:italic> &amp;lt; 0.000) along with more underlying comorbidities (3.0; <jats:italic>p<\/jats:italic> &amp;lt; 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1023229","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:06:02Z","timestamp":1665061562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Does the intubation timeline affect the in-hospital mortality of COVID-19 patients? A retrospective cohort study"],"prefix":"10.3389","volume":"9","author":[{"given":"Shazia","family":"Rehman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Ali","family":"Shahiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mundher A.","family":"Khaleel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ond\u0159ej","family":"Hol\u00fd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3481","DOI":"10.3390\/ijerph17103481","article-title":"Understanding knowledge and behaviors related to CoViD\u221219 epidemic in Italian undergraduate students: the EPICO study","volume":"17","author":"Gall\u00e8","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.3390\/healthcare9111468","article-title":"Association of mortality-related risk factors in patients with COVID-19: a retrospective cohort study","volume":"9","author":"Rehman","year":"2021","journal-title":"Healthcare."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.3390\/ijerph17062032","article-title":"The impact of COVID-19 epidemic declaration on psychological consequences: a study on active Weibo users","volume":"17","author":"Li","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3390\/biology9030050","article-title":"Understanding unreported cases in the COVID-19 epidemic outbreak in Wuhan, China, and the importance of major public health interventions","volume":"9","author":"Liu","year":"2020","journal-title":"Biology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1007\/s00134-020-06033-2","article-title":"COVID-19 pneumonia: different respiratory treatments for different phenotypes?","volume":"46","author":"Gattinoni","year":"2020","journal-title":"Inten Care Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/psb.1843","article-title":"COVID-19: a brief history and treatments in development","volume":"31","author":"Chaplin","year":"2020","journal-title":"Prescriber."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-021-03780-6","article-title":"Evolving outcomes of extracorporeal membrane oxygenation support for severe COVID-19 ARDS in Sorbonne hospitals, Paris","volume":"25","author":"Schmidt","year":"2021","journal-title":"Crit Care."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13287-020-01678-8","article-title":"Mesenchymal stem cells as a potential therapy for COVID-19","volume":"11","author":"Liu","year":"2020","journal-title":"Stem Cell Res Ther."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1001\/jama.2020.5394","article-title":"Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA."},{"key":"B10","doi-asserted-by":"publisher","first-page":"614152","DOI":"10.3389\/fmed.2020.614152","article-title":"Effect of early vs. delayed or no intubation on clinical outcomes of patients with COVID-19: an observational study","volume":"7","author":"Siempos","year":"2020","journal-title":"Front Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-021-03540-6","article-title":"Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies","volume":"25","author":"Papoutsi","year":"2021","journal-title":"Crit Care."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2847","DOI":"10.3390\/jcm9092847","article-title":"Clinical significance of timing of intubation in critically ill patients with COVID-19: a multi-center retrospective study","volume":"9","author":"Lee","year":"2020","journal-title":"J Clin Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-021-03598-2","article-title":"Timing of intubation in COVID-19 ARDS: what \u201ctime\u201d really matters?","volume":"25","author":"Tsolaki","year":"2021","journal-title":"Crit Care."},{"key":"B14","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1177\/0310057X211007862","article-title":"Early intubation versus late intubation for COVID-19 patients: an in situ simulation identifying factors affecting performance and infection control in airway management","volume":"49","author":"Lee","year":"2021","journal-title":"Anaesth Intens Care."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-021-03761-9","article-title":"Early versus late awake prone positioning in non-intubated patients with COVID-19","volume":"25","author":"Kaur","year":"2021","journal-title":"Crit Care."},{"key":"B16","doi-asserted-by":"publisher","first-page":"78","DOI":"10.15441\/ceem.20.043","article-title":"Rethinking the early intubation paradigm of COVID-19: time to change gears?","volume":"7","author":"Rola","year":"2020","journal-title":"Clin Exp Emerg Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1111\/anae.15054","article-title":"Consensus guidelines for managing the airway in children with COVID-19","volume":"75","author":"Cook","year":"2020","journal-title":"Anaesthesia."},{"key":"B18","doi-asserted-by":"publisher","first-page":"105","DOI":"10.24920\/003724","article-title":"Expert recommendations for tracheal intubation in critically ill patients with noval coronavirus disease 2019","volume":"35","author":"Zuo","year":"2020","journal-title":"Chinese Med Sci J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-020-03197-7","article-title":"A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection","volume":"24","author":"Cruces","year":"2020","journal-title":"Crit Care."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2329","DOI":"10.1001\/jama.2020.6825","article-title":"Management of COVID-19 respiratory distress","volume":"323","author":"Marini","year":"2020","journal-title":"JAMA."},{"key":"B21","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.3390\/ijerph19053075","article-title":"Comparison of early and late intubation in COVID-19 and its effect on mortality","volume":"19","author":"McKay","year":"2022","journal-title":"Inter J Environ Res Public Health."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1097\/ALN.0000000000003296","article-title":"Intubation and ventilation amid the COVID-19 outbreak: Wuhan's experience","volume":"132","author":"Meng","year":"2020","journal-title":"Anesthesiology."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-021-93739-y","article-title":"Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis","volume":"11","author":"Behesht Aeen","year":"2021","journal-title":"Sci Rep."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13613-020-00716-1","article-title":"Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study","volume":"10","author":"Diehl","year":"2020","journal-title":"Ann Intens Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e00596","DOI":"10.1002\/rcr2.596","article-title":"High-dose, short-term corticosteroids for ARDS caused by COVID-19: a case series","volume":"8","author":"So","year":"2020","journal-title":"Respirol Case Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-020-02911-9","article-title":"Acute respiratory failure in COVID-19: is it \u201ctypical\u201d ARDS?","volume":"24","author":"Li","year":"2020","journal-title":"Critical Care."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2194","DOI":"10.1016\/j.ajem.2020.06.082","article-title":"Initial emergency department mechanical ventilation strategies for COVID-19 hypoxemic respiratory failure and ARDS","volume":"38","author":"Lentz","year":"2020","journal-title":"Am J Emerg Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13613-020-00692-6","article-title":"Caution about early intubation and mechanical ventilation in COVID-19","volume":"10","author":"Tobin","year":"2020","journal-title":"Ann Intens Care."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e0262","DOI":"10.1097\/CCE.0000000000000262","article-title":"Timing of intubation and its implications on outcomes in critically ill patients with coronavirus disease 2019 infection","volume":"2","author":"Matta","year":"2020","journal-title":"Crit Care Explor."},{"key":"B30","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.ajem.2021.01.068","article-title":"Non-invasive positive pressure ventilation versus endotracheal intubation in treatment of COVID-19 patients requiring ventilatory support","volume":"43","author":"Daniel","year":"2021","journal-title":"Am J Emerg Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.7150\/ijms.50039","article-title":"Risk factors for mortality of critically ill patients with COVID-19 receiving invasive ventilation","volume":"18","author":"Tu","year":"2021","journal-title":"Int J Med Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.pulmoe.2020.04.013","article-title":"COVID-19 pandemic and non invasive respiratory management: every Goliath needs a David. An evidence based evaluation of problems","volume":"26","author":"Winck","year":"2020","journal-title":"Pulmonology."},{"key":"B33","doi-asserted-by":"publisher","first-page":"3890","DOI":"10.3390\/ijerph16203890","article-title":"Quality of care for patients with acute myocardial infarction (AMI) in Pakistan: a retrospective study","volume":"16","author":"Rehman","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"117583","DOI":"10.1016\/j.lfs.2020.117583","article-title":"COVID-19: Melatonin as a potential adjuvant treatment","volume":"250","author":"Zhang","year":"2020","journal-title":"Life Sci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"100052","DOI":"10.1016\/j.medidd.2020.100052","article-title":"Inhibition of metalloproteinases in therapy for severe lung injury due to COVID-19","volume":"7","author":"Solun","year":"2020","journal-title":"Med Drug Discov."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.3390\/antiox10081221","article-title":"Acute lung injury biomarkers in the prediction of COVID-19 severity: total thiol, ferritin and lactate dehydrogenase","volume":"10","author":"Martinez Mesa","year":"2021","journal-title":"Antioxidants."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e0242651","DOI":"10.1371\/journal.pone.0242651","article-title":"Outcomes of mechanically ventilated patients with COVID-19 associated respiratory failure","volume":"15","author":"King","year":"2020","journal-title":"PLoS ONE."},{"key":"B38","doi-asserted-by":"publisher","first-page":"100310","DOI":"10.1016\/j.ejro.2020.100310","article-title":"Ventilator associated lung injury in severe COVID-19 pneumonia patients\u2013Case Reports: ventilator associated lung injury in COVID-19","volume":"8","author":"Gupta","year":"2021","journal-title":"Eur J Radiol Open."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1604599","DOI":"10.3389\/ijph.2022.1604599","article-title":"Cardiovascular disease mortality and potential risk factor in China: a multi-dimensional assessment by a grey relational approach","volume":"67","author":"Rehman","year":"2022","journal-title":"Int J Public Health."},{"key":"B40","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1007\/s00134-020-06340-8","article-title":"Pondering the atypicality of ARDS in COVID-19 is a distraction for the bedside doctor","volume":"47","author":"Tobin","year":"2021","journal-title":"Intens Care Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1007\/s00134-020-06022-5","article-title":"Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19)","volume":"46","author":"Alhazzani","year":"2020","journal-title":"Intens Care Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/S2213-2600(20)30268-X","article-title":"Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study","volume":"8","author":"Coppo","year":"2020","journal-title":"Lancet Respir Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"e19","DOI":"10.1016\/S2213-2600(20)30084-9","article-title":"Staff safety during emergency airway management for COVID-19 in Hong Kong","volume":"8","author":"Cheung","year":"2020","journal-title":"Lancet Respir Med."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1023229\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T13:06:08Z","timestamp":1665061568000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1023229\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":43,"alternative-id":["10.3389\/fmed.2022.1023229"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.1023229","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,6]]},"article-number":"1023229"}}