Measuring the Risk Among Clinicians Who Intubate Patients with COVID-19

PHILADELPHIA—A team at the Perelman School of Medicine at the University of Pennsylvania launched the United States component of a global registry that aims to help protect health care providers who intubate patients with COVID-19 and better quantify their risk of developing the disease. The intubateCOVID registry—established by a team in the United Kingdom—tracks exposures and outcomes among providers who perform intubations, with the ultimate goal of reducing the transmission of COVID-19 to these providers.

About one percent of patients with COVID-19—a respiratory illness caused by the novel coronavirus, SARS-CoV-2—require mechanical ventilation to help keep their oxygen levels stable. In order to provide that support, health care providers—such as anesthesiologists, nurse anesthetists, and emergency or critical care physicians—first must place a breathing tube that can then be connected to a ventilator.

“Placing a breathing tube in patients with COVID-19 can pose a high risk to health care workers, as it may expose them to aerosols and droplets from a patient’s airways,” said Mark Neuman, MD, the Horatio C. Wood Associate Professor of Anesthesiology at Penn and the national lead for intubateCOVID. “In order to inform and best protect clinicians performing these procedures, it’s imperative we understand how participating in intubation procedures may be linked to an individual’s risk of developing COVID-19.”

Early data suggests front-line healthcare workers may have a higher incidence rate of COVID-19 than the general public. However, there’s no large-scale data that quantifies whether people who perform specific procedures, like an intubation, have an even higher risk of developing the disease. The registry, which was launched by anesthesiologists at the London-based Guy’s and St Thomas’ NHS Foundation Trust, not only will help to answer this question, but will also address how specific techniques used or the type of personnel protective equipment (PPE) worn affects one’s risk.

The registry is open to physicians and non-physicians who perform airway management procedures, including certified registered nurse anesthetists and anesthesiologist assistants. Providers are encouraged to record every intubation they perform on patients with confirmed or suspected COVID-19. During each submission, providers can include specific details, such as the airway technique and the PPE used. Then, in the days and weeks following the procedures, participants can add any new symptoms they experience or—in some cases—a diagnosis of COVID-19.

So far, more than 2,000 providers across 500 hospitals worldwide have joined the global registry, with data on more than 1,550 intubations. Penn is the national coordinating center for the United States. In addition to the United States launch, IntubateCOVID has gone live in Australia, New Zealand, Ireland, Sweden, Germany, the Netherlands, South Africa, and Canada. Additional countries expected to launch the coming days and weeks.

“Our goal is to rapidly capture and analyze large-scale data to identify whether these providers are at an elevated risk and, if so, whether the use of specific techniques or PPE helps to reduce that risk,” Neuman said.

For more information, visit intubatecovid.org.

 

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the  (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report’s survey of research-oriented medical schools. The School is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $425 million awarded in the 2018 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Home Care and Hospice Services, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 40,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2018, Penn Medicine provided more than $525 million to benefit our community.

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