Impact of Mechanical Ventilation on COVID-19 Patients in the Intensive Care Unit: A Retrospective Study

Abstract Introduction: Mechanical ventilation is frequently utilised in critically ill COVID-19 patients, yet outcomes remain unclear. This study evaluated characteristics, outcomes and associations between mechanical ventilation and prognosis in COVID-19 patients admitted to the intensive care unit (ICU). Methods: A retrospective review was conducted of medical records from 1389 COVID-19 patients admitted to a single ICU between dates. Demographic, clinical, treatment data and outcomes including length of stay (LOS), microbiological cure and discharge status were collected. Comparisons were made between ventilated and non-ventilated patients. Results: The mean age was 56 years, 74% were male. Mechanical ventilation was utilised in 73.9% for a mean duration of 9.89 days. Ventilated patients had significantly longer ICU (15 days vs. 10 days) and hospital stays (22 days vs. 18 days). Microbiological cure was achieved in 16.1%, with higher rates in ventilated patients. Factors including older age, male gender, diabetes and higher body mass index correlated with worse outcomes. Ventilated patients more often experienced ICU (96% vs. 4%) and hospital mortality (60% vs. 40%). Mechanical ventilation duration positively correlated with ICU and hospital LOS. Longer ventilation durations correlated with cure and remaining in ICU. Conclusion: In this large cohort, mechanical ventilation was commonly utilised yet correlated with worse outcomes, although outcomes may be confounded by indication. Modifying risk profiles through glycaemic and weight control along with standardised evidence-based protocols may help optimise outcomes. Further prospective analyses accounting for the severity of illness are needed to determine causal relationships between ventilation and prognosis in COVID-19.