Impact of the Covid19 pandemic on survival of patients with home mechanical ventilation(HMV)

Introduction: COVID19 produced an increase in deaths from respiratory diseases. Patients with HMV represent a vulnerable group and, moreover, the pandemic altered their usual follow-up. The aim of the study is to assess the impact of the pandemic on the mortality of these patients. Methods: Retrospective study of HMV patients who died during 2019-2020-2021. We collected clinical variables, years of ventilation and time since last visit. The difference in proportionality between prepandemic mortality and the pandemic period was analyzed. A descriptive analysis of the variables was carried out, comparing the results between the two periods using Fisher/Kruskal-Wallis for non-normal variables and Chi2/ANOVA for normal variables. Results: Compared to 2019, there was an increase in proportional mortality of 20% (2020) and 7% (2021). The results are shown in Figure 1. The time between the last visit and the moment of death was higher in the pandemic period; 2020: 126 days (50-252), 2021: 129 days (61-414), compared to the pre-pandemic period: 64 days (28-170); p<0.014. The cause of death by COVID19 was 10 cases (13%) in 2020 and 5 (6%) in 2021. Conclusions: The pandemic represented an increase in the mortality of HMV patients. Apart from the direct effect of the infection, a disruption care may have favored this increase. To minimize it, it is important to create structures that allow adequate monitoring, such as telemedicine.