This is a summary, written by members of the CITF Secretariat, of:

Leeies M, Rosychuk RJ, Ismath M, Xu K, Archambault P, Fok PT, Audet T, Jelic T, Hayward J, Daoust R, Chandra K, Davis P, Yan JW, Hau JP, Welsford M, Brooks SC, Hohl CM; Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) investigators for the Network of Canadian Emergency Researchers, the Canadian Critical Care Trials Group. Intubation practices and outcomes for patients with suspected or confirmed COVID-19: a national observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). CJEM. 2023 Apr;25(4):335-343. doi:

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

A CITF-funded study, published in the Canadian Journal of Emergency Medicine, found that intubation was completed successfully on the first try in 94% of cases for both COVID-19 and non-COVID-19 patients presenting to the emergency department. Intubation is a medical procedure where a flexible tube is placed into a person’s airway, usually through the mouth or nose to help a person breathe. These findings provide reassuring evidence that intubation processes that were adapted across Canada to protect healthcare workers from exposure to SARS-CoV-2 did not compromise patient outcomes compared to pre-pandemic practices. This study was led by Dr. Corinne Hohl (University of British Columbia) in collaboration with Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) investigators.

Key findings:

  • Patients found to have SARS-CoV-2 when presenting to hospital had lower oxygen levels than SARS-CoV-2 negative patients.
  • Most patients (92.4%) had intubation successfully on the first try, and this success rate was similar for both COVID-19 and non-COVID-19 patients.
  • Adverse events following intubation were relatively low (8.5% overall), with a higher proportion of SARS-CoV-2 positive patients experiencing hypoxemiaLow oxygen levels in the blood, which make a person feel short of breath or tired. (4.5%) compared to SARS-CoV-2 negative patients (2.2%).
  • Patients who had adverse events relating to intubation had higher in-hospital mortality than those that did not experience adverse events (43.2% vs. 33.2%). There was no difference, however, in mortality associated with adverse events based on SARS-CoV-2 status.
  • The intensive care unit (ICU) length of stay was greater for patients who experienced adverse events following intubation than those who did not (nine days versus six days), with SARS-CoV-2 positive patients having longer ICU length of stay than SARS-CoV-2 negative patients.

The authors highlight that future research should delve into the causal relationship between intubation-related adverse events and patient morbidity or mortality. Additionally, ongoing evaluation of the multi-component intubation process interventions employed during the pandemic is crucial.

This health records review enrolled 1,720 patients using the CCEDRRN registry. Patients were recruited from 47 emergency departments across Canada between March 1, 2020, and June 20, 2021. They were tested for SARS-CoV-2 and underwent intubation in the emergency department.