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1. Outcome of 1890 tracheostomies for critical COVID-19 patients: a national cohort study in Spain

Author

Martin-Villares, Cristina, Perez Molina-Ramirez, Carmen, Bartolome-Benito, Margarita, Bernal-Sprekelsen, Manuel, Perez-Fernandez, Aranzazu, Alcantara-Armenteros, Sara, Monjas-Cánovas, Irene, Sancho-Mestre, Manuela, Alemán-Lopez, Oscar, Deola-Trasserra, M Dolors, Villarraga-Cova, Vanessa, Carreras-Alcaraz, Azor, Montaner-Sala, Esther, Sota-Eguizabal, Esther, Tolosa, Aihnoa, De la Iglesia, Belen, Garcia-Sardon, Rafael, Diez, Laura, Lehrer, Eduardo, Aviles-Jurado, Francisco Xavier, Tudela-Cabello, Kiara, Huguet-Llull, Gabriel, Mesalles-Ruíz, Marta, Jimenez-Montoya, Ramon, Navazo-Eguïa, Ana, Galindo-Torres, Blanca, Fernandez-Pello, Marta, Rodriguez-Prado, Nuria, Salazar, Carmen, Ramos, Francisco, Amor-Dorado, Juan Carlos, Faubel-Serra, Marta, Nuñez-Carrasco, Valery, Agüero-Medina, Adriana, Carlos-Villatoro, Juan, Lopez-Diu, Roser, Gonzalez-Melgan, Selvyn, Uzcanga-Lacabe, María, Cardier-Suárez, Marisela, Úbeda-Fernández, Esther, Alañon-Fernández, Miguel Ángel, Sanchez-Herrero, Carlos, Municio-Martin, Jose Antonio, Pascua-Gomez, Luis, Andrino-Martin, Sergio, Ayala-Mejias, Sandra, Molina-Gil, Bárbara, De Abajo-Larriba, Jorge, Piñeiro-Aguín, Zenaida, Gil-Carcedo, Elisa, Herrero-Agustín, Javier, Freijanes-Otero, Jorge, Cuetos-Azcona, Mario, Garcia-Fernandez, Alfredo, Jimenez-Huerta, Ignacio, Babarro-Fernández, Rosa, Junjgohann-Jofre, Felipe, Martel-Lopez, Antonio, Martin-Sanchez, Maria Dolores, Benitez-del Rosario, Jesus, Luorido, Diana, Granda, Monica, Tejeda, Jose Miguel, Martinez Ruiz-Coello, Antonio, Almodovar-Iniesta, Antonio, Bonnin, Jesus, Chao-Vietes, Jacobo, Hernández-Garcia, Estefanía, Plaza, Guillermo, Villacampa-Auba, Jose Miguel, Campos-Gonzalez, Alfonso, Casqueiro, Jose Carlos, Baguena-Campos, Lucia, Encinas-Vicente, Alberto, Rubio-Yanguas, Raul, Lowy-Benoliel, Alejandro, Poletti-Serafini, Daniel, Pasamontes-Pingarron, Juan Antonio, Aristegui-Ruiz, Miguel, Hernando-Cuñado, Monica, Souviron-Encabo, Rosalia, Martinez-Guirado, Tomas, Fernandez-Fernandez, Mario, Gonzalez-Orus, Ricardo, Molina-Montes, Beatriz, De la Fuente-Hernandez, Raquel, Crovato-Rojas, Jesús, Ruminot, Cristian, Laguado, Daniella, Acosta, Hander, Hernández-Garcia, María José, Zuaza-Gonzalez, Alejandro, Domingo-Carrasco, Carlos, Valor-García, Cristina, Lopez-Martin, Javier, Mogollon-Cano, Tomas, Meler-Claramonte, Carla, Flores-Martín, Juan Carlos, Arzok del Toro, Juanjo, Garcia-Piñero, Alfonso, Muñoz-Fernandez, Noelia, del Palacio, Antonio, Mateos-Serrano, Blanca, Garcia-Lopez, Isabel, Rodrigañez-Riesco, Laura, Aragon, Paula, Rivera, Teresa, Eisenberg-Plaza, Gustavo, Fernandez-Robledo, Inmaculada, Prada-Pendolero, Jorge, Alvarez-Alvarez, Ignacio, Puente-Verez, Maria, Quintana-Sanjuas, Ana, Parente-Arias, Pablo, García-Cordoba, Francisco, Garcia-Purriños, Francisco Jose, Morales-Angulo, Carmelo, Rodriguez-Rondon, Simara, Lopez-Lopez, Diana, Fernandez-Liesa, Rafael, Lázaro-Sánchez, Amaya, Alonso-Alonso, I, Rusiecka, Michalina, Ramirez, Rosa Delia, Vila, Javier, Bellmunt-Fontanet, Angela, Montoro-Martinez, Victoria, Piqueras, Francisco, Novoa-Morales, Vania, Simonetti, Gabriela, Guillen-Lozada, Enrique, Velasco, Maria Jesus, Alonso-Castiñeira, Ignacio, Hernandez, Maria, Rovira-Ramos, Carlota, Diaz-Argüello, Juan Jose, Escamilla-Carpintero, Yolanda, Torrico-Roman, Pablo, Calvo-Navarro, Carlos, Viza-Puiggros, Ignacio, Vaduva, Cristina, Higuera-Lucas, Juan, Tato, Jose Ignacio, Rivera-Rodriguez, Teresa, Rodriguez-Contreras, Diego, Caravaca-Garcia, Antonio, Ayala, Alejandra, Morales-Puebla, José Manuel, Ruiz-Escudero, Carlos, Lozano-Reina, E, Maza-Solano, Juan Manuel, Alfaro-Garcia, Jorge, Sanchez, Fatima, Montes-Jovellar, Luordes, Medina, Mar, Barbera, Rafael, Marco-Garrido, Alfonso, Cremades-Navalon, Isabel, García-Callejo, Javier, Bastida, C Garcia, Gutierrez-Fonseca, Raimundo, Muñoz-Herrera, Angel, Calvo, Marta, Rosal-Fraga, Carmen, Iglesias-Moreno, Mari Cruz, Gimeno-Hernández, Jesus, Vázquez-Romero, Cristina A, Alzate-Amaya, Fabian, Palomino, Laura, Alcaraz, Marta, Romeu-Figuerola, Coia, Foglia-Fernandez, Maria, Dios-Loureiro, Cristina, Gonzalez-Guijarro, Isabel, Vera-Llao, Rafael, Sancho-Calvo, Rosa, Ramos-Fernandez, Jesus Jose, Lasso-delaVega, Mar, Martinez-Pascual, Paula, Dominguez-Ovejas, Silvia, Morera-Senra, Eduardo, Alba-Mesquida, Jacoba, Bonilla, Alfonso, Martinez-Subias, Javier, Martinez-Salazar, Jesus M, Martinez-Lapeña, Antonio, Corrales-Millan, Rocio, Ruiz, Rosario, Mata, Nieves, Espinosa, Alfredo, Cianci-Jaimes, Laura Gerarda, Zapater-Latorre, Enrique, Alba-Garcia, Jose Ramon, Oishi-Konari, Miriam Natsuki, Pallares-Marti, Beatriz, Rubio-Fernandez, Andrea, Santos-Pérez, Jaime, Idigora-Planas, Albert, Sanchez-Barrueco, Alvaro, Alcala-Rueda, Ignacio, Jara-Rubio, Ruben, Lozano, Estefanía, Tirado-Zamora, Isabel, Coscaron-Blanco, Enrique, Suarez-Ortega, Soledad, Gil-Grasa, Guillermo, Lavilla-Martin de Valmaseda, Maria Jose, Sebastian, Jose Miguel, Nijim, Hazem, Dominguez-Calvo, Jesus, Gonzalez-Gimeno, Maria Jose, Carvajal-Urueña, Ana, Anel, Luis, and Gonzalo-Orden, Manuel

Subjects
medicine.medical_specialty, Percutaneous, medicine.medical_treatment, law.invention, Cohort Studies, 03 medical and health sciences, Tracheostomy, Mechanical ventilation, 0302 clinical medicine, law, medicine, Humans, Weaning, Intensive care unit, 030223 otorhinolaryngology, Retrospective Studies, SARS-CoV-2, business.industry, General surgery, COVID-19, General Medicine, Respiration, Artificial, Otorhinolaryngology, Spain, 030220 oncology & carcinogenesis, Cohort, Observational study, Neurosurgery, business, Head and Neck
Abstract

Background The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. Methods A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival. Results We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4–42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cut-off time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients. Conclusion To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.

Published
2020
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2. Risk of contagion of SARS-CoV-2 among otorhinolaryngologists in Spain during the 'Two waves'

Author

Martin-Villares, Cristina, Bernal-Sprekelsen, Manuel, Molina-Ramirez, Carmen Perez, Bartolome-Benito, Margarita, Aristegui-Ruiz, M., Agüero-Medina, Adriana, Tolosa, Aihnoa, Maturana, Aitor Zabala-Lopezde, Idigora-Planas, Albert, Codina-Aroca, Alberto, Encinas-Vicente, Alberto, Sanchez-Tudela, Alberto, Ayala, Alejandra, Lowy-Benoliel, Alejandro, Zuaza-Gonzalez, Alejandro, Bonilla-Perez, Alfonso, Campos-Gonzalez, Alfonso, Garcia-Piñero, Alfonso, Marco-Garrido, Alfonso, Garcia-Fernandez, Alfredo, Trinidad, Almudena, Sanchez-Barrueco, Alvaro, Lázaro-Sánchez, Amaya, Piñeiro, Z, Navazo-Eguïa, Ana, Quintana-Sanjuas, Ana, Rubio-Fernandez, Andrea, Moreno-Juara, Angel, Muñoz-Herrera, Angel, Bellmunt-Fontanet, Angela, Almodovar-Iniesta, Antonio, Caravaca-Garcia, Antonio, del Palacio, Antonio, Martel-Lopez, Antonio, Martinez-Lapeña, Antonio, MartinezRuiz-Coello, Antonio, Perez-Fernandez, Aranzazu, Carreras-Alcaraz, Azor, Molina-Gil, Bárbara, Molina-Montes, Beatriz, Pallares-Marti, Beatriz, De la Iglesia, Belen, Galindo-Torres, Blanca, Mateos-Serrano, Blanca, Garcia-Bastida, C., Meler-Claramonte, Carla, Calvo-Navarro, Carlos, Domingo-Carrasco, Carlos, Escobar-Sanchez, Carlos, Sanchez-Herrero, Carlos, Rovira-Ramos, Carlota, Morales-Angulo, Carmelo, Rosal-Fraga, Carmen, Salazar, Carmen, Orus, Cesar, Romeu-Figuerola, Coia, Ruminot, Cristian, Vázquez-Romero, Cristina A., Dios-Loureiro, Cristina, Valor-García, Cristina, Poletti-Serafini, Daniel, Laguado, Daniella, Lopez-Lopez, Diana, Luorido, Diana, Rodriguez-Contreras, Diego, Morera-Serna, Eduardo, Gil-Carcedo, Elisa, Coscaron-Blanco, Enrique, Guillén-Lozada, Enrique, Zapater-Latorre, Enrique, Hernández-Garcia, Estefanía, Lozano, Estefanía, Montane-Sala, Esther, Sota-Eguizabal, Esther, Úbeda-Fernández, Esther, Alzate-Amaya, Fabian, Sanchez-Fernandez, Fatima, Junjgohann-Jofre, Felipe, García-Cordoba, Francisco, Garcia-Purriños, Francisco Jose, Ramos, Francisco, Huguet-Llull, Gabriel, Simonetti, Gabriela, Gil-Grasa, Guillermo, Plaza, Guillermo, Eisenberg-Plaza, Gustavo, Acosta, Hander, Alonso-Alonso, I., Alcala-Rueda, Ignacio, Alvarez-Alvarez, Ignacio, Jimenez-Huerta, Ignacio, Viza-Puiggros, Ignacio, Clemente, Ignacio, Fernandez-Robledo, Inmaculada, Monjas-Cánovas, Irene, Castillo-Lopez, Irma Yolanda, Cremades-Navalon, Isabel, Garcia-Lopez, Isabel, Gonzalez-Guijarro, Isabel, Tirado-Zamora, Isabel, Alba-Mesquida, Jacoba, Chao-Vietes, Jacobo, Santos-Pérez, Jaime, García, Javier, Herrero-Agustín, Javier, Lopez-Martin, Javier, Martinez-Subias, Javier, Vila, Javier, Rosario, Jesus Benitez-del, Crovato-Rojas, Jesús, Gimeno-Hernández, Jesus, Dominguez-Calvo, Jesus Ignacio, Ramos-Fernandez, Jesus Jose, Martinez-Salazar, Jesus M., Alfaro-Garcia, Jorge, De Abajo-Larriba, Jorge, Freijanes-Otero, Jorge, Prada-Pendolero, Jorge, Municio-Martin, Jose Antonio, Casqueiro, Jose Carlos, Tato, Jose Ignacio, Sebastian, Jose Miguel, Tejeda, Jose Miguel, Villacampa-Auba, Jose Miguel, Morales, JManuel, Alba-Garcia, Jose Ramon, Dalmau, Josep, Pasamontes-Pingarron, Juan Antonio, Amor-Dorado, Juan Carlos, Flores-Martín, Juan Carlos, Carlos-Villatoro, Juan, Higuera-Lucas, Juan, Toro, Juan Jose Artazkoz-del, Diaz-Argüello, Juan Jose, Tudela-Cabello, Kiara, Rubio-Yanguas, L., Cianci-Jaimes, Laura Gerarda, Palomino, Laura, Rodrigañez-Riesco, Laura, Montes-Jovellar, Lourdes, Baguena-Campos, Lucia, Pascua-Gomez, Luis, Deola-Trasserra, MDolors, Cueva-Díaz, Jenifer, Sancho-Mestre, Manuela, Lasso-delaVega, Mar, Medina, Mar, Iglesias-Moreno, Mari Cruz, Martin-Sanchez, Maria Dolores, Foglia-Fernandez, María, Velasco, Maria Jesus, Jesús-Dominguez, Maria, Hernández-Garcia, María José, de Valmaseda, Maria Jose Lavilla-Martin, Gonzalez-Gimeno, Maria José, Puente-Verez, Maria, Uzcanga-Lacabe, María, Cuetos-Azcona, Mario, Fernandez-Fernandez, Mario, Vazquez, Mariano Andres, Cardier-Suárez, Marisela, Alcaraz, Marta, Calvo, Marta, Estévez, M., Faubel-Serra, Marta, Fernandez-Pello, Marta, Mesalles-Ruíz, Marta, Rusiecka, Michalina, Alañon-Fernández, Miguel Ángel, Oishi-Konari, Miriam Natsuki, Granda, Monica, Hernando-Cuñado, Monica, Muñoz-Fernandez, Noelia, Rodriguez-Prado, Nuria, Alemán-Lopez, Oscar, Parente-Arias, Pablo, Torrico-Roman, Pablo, Aragon, Paula, Martinez-Pascual, Paula, Barbera, Rafael, Fernandez-Liesa, Rafael, Garcia-Sardon, Rafael, Gutierrez-Fonseca, Raimundo, Jimenez-Montoya, Ramon, De la Fuente-Hernandez, Raquel, Raquelortiz-Rodrigo, Gonzalez-Orus, Ricardo, Corrales-Millan, Rocio, Ramirez, Rosa Delia, Fernandez, Rosa Babarro, Sancho-Calvo, Rosa, Souviron-Encabo, Rosalia, Almela-Cortes, Rosana, Ruiz-Gomez, Rosario, Lopez-Diu, Roser, Jara-Rubio, Ruben, Alcantara-Armenteros, Sara, Tamboura, Sara, Santos-Santos, Saturnino, Gonzalez-Melgan, Selvyn, Andrino-Martin, Sergio, Dominguez-Ovejas, Silvia, Rodriguez-Rondon, Simara, Suarez-Ortega, Soledad, Rivera, Teresa, Rivera-Rodriguez, Teresa, Martinez-Guirado, Tomas, Mogollon-Cano, Tomas, Nuñez-Carrasco, Valery, Villarraga-Cova, Vanessa, Montoro-Martinez, Victoria, and Escamilla-Carpintero, Yolanda

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Short Communication, Population, Communicable diseases, 03 medical and health sciences, Otolaryngology, 0302 clinical medicine, Otorrinolaringologia, Pandemic, Otolaryngologists, medicine, Mortalitat, Humans, Mortality, 030223 otorhinolaryngology, education, Pandemics, education.field_of_study, business.industry, SARS-CoV-2, COVID-19, General Medicine, Malalties infeccioses, medicine.disease, Pneumonia, Morbiditat, Otorhinolaryngology, Spain, 030220 oncology & carcinogenesis, Emergency medicine, Cohort, Observational study, Morbidity, business
Abstract

Introduction The aim of our study was to obtain data about the contagion rate among Otolaryngologists in Spanish ENT Departments and about the clinical outcomes in positive otolaryngologists. As a secondary objective, we aim to assess the rate of contagion in the first and the second Covid-19 wave in Spain among Otorhinolaryngologists and the regional distribution by ENT-Departments. Methods Study design and population: This is a prospective observational study in a cohort of 975 Otolaryngologists from 87 ENT Departments conducted from March 25 to November 17 in our collaborative group, COVID ORL ESP. COVID‐19 polymerase chain reaction (PCR) was the diagnostic standard. Hospitalization and/or intensive care admission and mortality was recorded as non-identified data. Results Data collected from 975 otolaryngologist from 87 Departments resulted in 157 (16.5%) otolaryngologists testing positive for SARS-CoV-19 by RT-PCR. Important geographic differences in contagion are reported. A total of 136 (86.6%) otolaryngologists were tested positive during the first wave and 21 (13.3%) during the second wave. At the last cut-off point of the study only 30/87 ENT Departments (34.5%) remained COVID19-free and 5 Departments reported more than 50% staff members testing positive. The majority of positive tested otolaryngologists (126/157; 80.2%) had only mild or no symptoms, 17 developed moderate symptoms (10.8%) and 3 had pneumonia not requiring hospitalization (2%). Five colleagues were admitted at hospital, 4 required ICU (2.5%) and 2 colleges died from COVID-19. Conclusions During the first wave of the SARS-CoV-19 pandemic otolaryngologists in Spain have been overall the group suffering the highest rate of contagion, particularly during the first month. Subsequently, the Spanish Ministry of Health should include otorhinolaryngologists as a high-risk group in airborne pandemics.

Published
2021

3. Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe COVID-19: A multicenter prospective cohort study

Author

Universitat Rovira i Virgili, Prats-Uribe, Albert; Tobed, Marc; Miguel Villacampa, Jose; Aguero, Adriana; Garcia-Bastida, Clara; Ignacio Tato, Jose; Rodriganez, Laura; Duque Holguera, Victoria; Hernandez-Garcia, Estefania; Poletti, Daniel; Simonetti, Gabriela; Villarraga, Vanessa; Meler-Claramonte, Carla; Sanchez Barrueco, Alvaro; Chiesa-Estomba, Carlos; Casasayas, Maria; Parente-Arias, Pablo; Mata-Castro, Nieves; Rello, Jordi; Castro, Pedro; Prieto-Alhambra, Daniel; Vilaseca, Isabel; Xavier Aviles-Jurado, Francesc;TraqueoCOVID SEORL Grp, Universitat Rovira i Virgili, and Prats-Uribe, Albert; Tobed, Marc; Miguel Villacampa, Jose; Aguero, Adriana; Garcia-Bastida, Clara; Ignacio Tato, Jose; Rodriganez, Laura; Duque Holguera, Victoria; Hernandez-Garcia, Estefania; Poletti, Daniel; Simonetti, Gabriela; Villarraga, Vanessa; Meler-Claramonte, Carla; Sanchez Barrueco, Alvaro; Chiesa-Estomba, Carlos; Casasayas, Maria; Parente-Arias, Pablo; Mata-Castro, Nieves; Rello, Jordi; Castro, Pedro; Prieto-Alhambra, Daniel; Vilaseca, Isabel; Xavier Aviles-Jurado, Francesc;TraqueoCOVID SEORL Grp

Abstract

Background Optimal timing for tracheotomy for critically ill COVID-19 patients requiring invasive mechanical ventilation (IMV) is not established. Methods Multicenter prospective cohort including all COVID-19 patients admitted to intensive care units (ICUs) in 36 hospitals who required tracheotomy during first pandemic wave. With a target emulation trial framework, we studied the causal effects of early (7-10 days) versus late (>10 days) tracheotomy (LT) on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Results Of 696 patients, 20.4% received early tracheotomy (ET). ET was associated with faster weaning (hazard ratio [HR] [95% confidence interval, CI]: 1.25 [1.00-1.56]) without differences in mortality (HR [95% CI]: 0.85 [0.60-1.21]) or complications (adjusted rate ratio [95% CI]: 0.56 [0.23-1.33]). Conclusions ET had a similar or lower post-tracheotomy weaning time than LT, potentially shortening IMV and ICU stays, without changing complication or mortality rates in COVID-19 patients.

Published
2021

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