Respiratory technologists in the frontlines against COVID-19

S D Maasdorp; M Pretorius; P Pienaar; E Rosslee; A Alexander; A van der Linde; C van Rooyen

Original research

Respiratory technologists in the frontlines against COVID-19

S D Maasdorp, M Pretorius, P Pienaar, E Rosslee, A Alexander, A van der Linde, C van Rooyen

Abstract

Background. The COVID-19 pandemic overwhelmed healthcare resources globally, but especially those of resource-limited countries. Strategies to supplement the number of healthcare workers attending COVID-19 patients had to be implemented. Several institutions used non-respiratory clinicians to work in COVID-19 wards. At Universitas Academic Hospital (UAH), Bloemfontein, South Africa, respiratory technologists were requested to assist with managing the oxygen supportive care of patients with severe COVID-19 and respiratory failure.

Objectives. To highlight the contribution that respiratory technologists made in the management of severe COVID-19 pneumonia patients by describing the baseline characteristics and mortality of patients with COVID-19, whose oxygen supportive care was managed primarily by respiratory technologists at UAH.

Methods. This was a retrospective study. The investigators extracted data from the hospital files of all adult patients admitted with severe COVID-19 to UAH and where respiratory technologists were involved in their care between 1 January and 31 December 2020.

Results. A total of 781 patients were admitted to UAH, of whom 106 fulfilled the inclusion criteria. The majority of the patients were female (n=68; 64.1%), and the median age (interquartile range (IQR)) was 59.5 (51 - 68) years. Hypertension (n=69; 65.1%) and diabetes mellitus (n=39; 36.8%) were the most frequent comorbidities. At the time of admission, the median oxygen saturation was 92% and the median respiratory rate oxygenation (ROX) index was 3.2. The median length of stay was 7 days and the mortality was 41.5%.

Conclusion. The clinical characteristics and mortality of patients whose oxygen support was managed by respiratory technologists were similar to those in previously reported studies from resource-limited settings. Respiratory technologists can form a valuable addition to the front-line team when clinicians and nurses are faced with overwhelming patient numbers in subsequent COVID-19 surges and where the mainstay of treatment is oxygen supportive care.

Authors' affiliations

S D Maasdorp, Division of Pulmonology, Department of Internal Medicine, and Division of Critical Care, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

M Pretorius, Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa

P Pienaar, Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa

E Rosslee, Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa

A Alexander, Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa

A van der Linde, Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa

C van Rooyen, Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa