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

doi:10.7196/AJTCCM.2022.v28i2.210

Respiratory technologists in the frontlines against COVID-19

Afr J Thorac Crit Care Med. 2022 Jul 15;28(2):10.7196/AJTCCM.2022.v28i2.210. doi: 10.7196/AJTCCM.2022.v28i2.210. eCollection 2022.

Authors

S D Maasdorp¹, M Pretorius², P Pienaar², E Rosslee², A Alexander², A van der Linde², C van Rooyen³

Affiliations

¹ 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.
² Division of Pulmonology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, and Universitas Academic Hospital, Bloemfontein, South Africa.
³ Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

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.

Keywords: COVID-19; Frontline; Respiratory technologist.