Clinical Characteristic and Outcome of COVID-19 Patients Using High Flow Nasal Oxygen in Persahabatan Hospital, Jakarta

Wahyu Soebekti, Feni Fitriani Taufik, Mia Elhidsi


Background: Severe and critical COVID-19 patient need intensive care and even invasive mechanical ventilation. Use of high flow nasal oxygen (HFNO) in acute hypoxemic respiratory failure on non-COVID-19 patient can reduce the need for intubation while in COVID-19 patient the data is still inadequate.

Methods: This is a retrospective cohort study in 62 confirmed COVID-19 patient using HFNO and treated at Persahabatan Hospital from March to July 2020. Demographic, clinical and laboratory data before HFNO and vital sign, respiratory index after 24 hours of HFNO was taken from medical record.

Results: Majority of patients are men (67%), mean age 57.6 years, comorbidity is mostly hypertension and diabetes. HFNO Success outcome is 45.2%. Statistically significant difference between success and failure group is noted on respiratory rate (24 vs 28.5), pulse rate (88.14 vs 100), oxygen saturation (98 vs 94), PaO2/Fio2 (139.27 vs 73), SpO2/FiO2 (116.98 v 102.78) and ROX index (4.97 vs 3.5). Vital sign and respiratory index measured after 24 hours of HFNO showed statistically significant improvement in success group.

Conclusion: HFNO can reduce intubation rate in patient with COVID-19. Vital sign and respiratory index are significantly improved in HFNO success group.


COVID-19; High flow nasal oxygen (HFNO); ROX index

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Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18):1708–20.

World Health Organization. Novel Coronavirus [Internet]. [cited 2020 May 3]. Available from:

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239–42.

World Health Organization. Clinical management of novel coronovirus. Geneva. World Health Organization; 2020.

Helviz Y, Einav S. A Systematic Review of the High-flow Nasal Cannula for Adult Patients. Crit Care. 2018; 22(1).

Rochwerg B, Granton D, Wang DX, Helviz Y, Einav S, Frat JP, et al. High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis. Intensive Care Med. 2019;45(5):563–72.

Wang K, Zhao W, Li J, Shu W, Duan J. The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China. Ann Intensive Care. 2020; 10(1).

Demoule A, Vieillard Baron A, Darmon M, Beurton A, Géri G, Voiriot G, et al. High Flow Nasal Canula in Critically Ill Severe COVID-19 Patients. Am J Respir Crit Care Med [Internet]. 2020 Aug 6 [cited 2020 Sep 2]; Available from:

Patel M, Gangemi A, Marron R, Chowdhury J, Yousef I, Zheng M, et al. Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure. BMJ Open Respir Res. 2020; 7(1):e000650.

Kang S-J, Jung SI. Age-Related Morbidity and Mortality among Patients with COVID-19. Infect Chemother. 2020; 52(2):154–64.

Gebhard C, Regitz-Zagrosek V, Neuhauser HK, Morgan R, Klein SL. Impact of sex and gender on COVID-19 outcomes in Europe. Biol Sex Differ. 2020; 25;11(1):29.

Gupta S, Hayek SS, Wang W, Chan L, Mathews KS, Melamed ML, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US. JAMA Intern Med. 2020; 180(11):1436.

Patanavanich R, Glantz SA. Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine Tob Res. 2020; 22(9):1653–6.

Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M, et al. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study. EClinicalMedicine. 2020; 28:100570.

WHO Solidarity Trial. Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results. N Engl J Med. 2020; 384:497-511.

Ashraf-Kashani N, Kumar R. High-flow nasal oxygen therapy. BJA Educ. 2017; 17(2):63–7.

Wang J, Jiang M, Chen X, Montaner LJ. Cytokine storm and leukocyte changes in mild versus severe SARS‐CoV‐2 infection: Review of 3939 COVID‐19 patients in China and emerging pathogenesis and therapy concepts. J Leukoc Biol. 2020; 108(1):17–41.

Wang S, Fu L, Huang K, Han J, Zhang R, Fu Z. Neutrophil-to-lymphocyte ratio on admission is an independent risk factor for the severity and mortality in patients with coronavirus disease 2019. J Infect [Internet]. 2020 Sep 23 [cited 2021 Jan 28];0(0). Available from:

Chen Y, Zhang K, Zhu G, Liu L, Yan X, Cai Z, et al. Clinical characteristics and treatment of critically ill patients with COVID-19 in Hebei. Ann Palliat Med. 2020; 9(4):2118–30.

Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis. 2020; 14:1753466620937175.

Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol [Internet]. 2020 Apr 28 [cited 2020 Jun 1]; Available from:

Deng X, Liu B, Li J, Zhang J, Zhao Y, Xu K. Blood biochemical characteristics of patients with coronavirus disease 2019 (COVID-19): a systemic review and meta-analysis. Clin Chem Lab Med CCLM. 2020; 58(8):1172–81.

Zhao B-C, Liu W-F, Lei S-H, Zhou B-W, Yang X, Huang T-Y, et al. Prevalence and prognostic value of elevated troponins in patients hospitalised for coronavirus disease 2019: a systematic review and meta-analysis. J Intensive Care. 2020; 8(1):1–15.



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