COVID-19 · Non-invasive support in COVID-19
High-Flow Nasal Cannula Oxygen vs Standard Oxygen Therapy in Respiratory Failure Due to COVID-19
| Design | Multicentre randomised clinical trial |
|---|---|
| Treatment | High-flow nasal oxygen |
| Control | Standard oxygen therapy |
| Population | 711 analysed patients with respiratory failure due to COVID-19, mean age 61, 30% women |
| Follow-up | 28 days |
| Primary endpoint | Mortality at day 28 |
| Result | Mortality at day 28 was 10% (36 of 357) with high-flow oxygen and 11% (40 of 354) with standard oxygen — no significant difference. |
| Secondary endpoints | Intubation, ventilator-free days, ICU length of stay |
Among patients with respiratory failure due to COVID-19, high-flow nasal cannula oxygen, compared with standard oxygen therapy, did not significantly reduce 28-day mortality.
The trial authors, in the published abstract
Agrees with the high-flow arm of RECOVERY-RS: in COVID-19 specifically, high-flow oxygen did not deliver what FLORALI suggested it might in other hypoxaemic failure. Comfort and tolerability remain reasonable grounds to use it; mortality reduction is not.
Frat JP, Quenot JP, Badie J, et al. Effect of High-Flow Nasal Cannula Oxygen vs Standard Oxygen Therapy on Mortality in Patients With Respiratory Failure Due to COVID-19: The SOHO-COVID Randomized Clinical Trial. JAMA 2022 Sep 27;328(12):1212-1222.