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High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection
  1. Andrea Vianello1,
  2. Giovanna Arcaro2,
  3. Beatrice Molena2,
  4. Cristian Turato3,
  5. Andi Sukthi2,
  6. Gabriella Guarnieri2,
  7. Francesca Lugato2,
  8. Gianenrico Senna4,
  9. Paolo Navalesi5
  1. 1 Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
  2. 2 Department of Cardiac, Thoracic and Vascular Sciences, University-City Hospital of Padova, Padova, Italy
  3. 3 Department of Molecular Medicine, University of Pavia, Pavia, Italy
  4. 4 Department of Medicine, University of Verona, Verona, Italy
  5. 5 Department of Medicine DIMED, University of Padova, Padova, Italy
  1. Correspondence to Professor Andrea Vianello, -, Padova 35128, Italy; andrea.vianello{at}


This observational study aims to assess the outcome and safety of O2-therapy by high-flow nasal cannula (HFNC) in 28 consecutive patients with severe hypoxemic acute respiratory failure (hARF) consequent to SARS-CoV-2 infection, unresponsive to conventional O2-therapy. Nineteen patients had a positive response. Nine patients required escalation of treatment to non-invasive ventilation (five subsequently intubated). None of the staff had a positive swab testing during the study period and the following 14 days. Severity of hypoxemia and C reactive protein level were correlated with HFNC failure. These data suggest HFNC to be a safe treatment for less severe patients with SARS-CoV-2 hARF and efficacy will need to be assessed as part of a clinical trial.

  • critical care
  • viral infection
  • respiratory infection
  • non invasive ventilation

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  • Contributors AV: study design, manuscript preparation. BM: data collection and analysis. CT: data collection and analysis. GA: data collection, conduction of the study. AS: conduction of the study. GG: data collection, conduction of the study. FL: data collection, conduction of the study. GS: study design, data analysis. PN: manuscript preparation, revision of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.