Evaluation of Mortality and Morbidity in COVID-19 Patients Treated with NIV (Non-invasive Ventilation): A 30-Day Follow-up Study

Background: The COVID-19 pandemic has led to a surge in acute respiratory failure cases, necessitating effective management strategies. Non-invasive ventilation (NIV) has emerged as a treatment option; however, its efficacy and associated mortality rates remain debated. Objectives: This study aims to evaluate the mortality and morbidity rates in COVID-19 patients treated with NIV. Methods: We conducted a retrospective analysis of 50 patients diagnosed with COVID-19 [confirmed by positive nasopharyngeal polymerase chain reaction (PCR)] who received NIV at Imam Reza Hospital and Sina Medical Training Centers in Tabriz, Iran. Data were collected between April 2021 and January 2022, including demographic characteristics, clinical symptoms, laboratory findings, and outcomes, such as complications and mortality rates. For data analysis, we used logistic regression, the Mann-Whitney U test for comparing quantitative variables, and Fisher's exact test for qualitative variables. Results: Among the 50 patients, 28 (56%) died during hospitalization. The median age of non-survivors was 66 years, significantly higher than that of survivors (56 years, P = 0.018). Older age and higher Quick sepsis-related organ failure assessment (QSOFA) scores were predictive of increased mortality (OR = 1.24; P = 0.001). Additionally, complications such as pneumothorax were observed in 14% of patients. Conclusions: Our findings highlight a concerning mortality rate following NIV failure in COVID-19 patients, emphasizing the need for careful patient selection and close monitoring. Clinicians should consider early intubation for patients showing signs of NIV failure, particularly those with risk factors such as older age and high QSOFA scores.