Tracheostomies of Patients With COVID-19: A Survey of Infection Reported by Health Care Professionals

Constance S Harrell Shreckengost; Limeng Wan; Alexandra W Reitz; Alice Lin; Rohan K Dhamsania; Julia Spychalski; J Miller Douglas; Andrea Lane; Dina Amin; Steven Roser; David Berkowitz; Jorge Esteban Foianini; Renée Moore; Jithin K Sreedharan; Abesh Niroula; Randi Smith; Onkar V Khullar; PTS-COVIDTrach Collaborative

doi:10.4037/ajcc2022337

Tracheostomies of Patients With COVID-19: A Survey of Infection Reported by Health Care Professionals

Am J Crit Care. 2023 Jan 1;32(1):9-20. doi: 10.4037/ajcc2022337.

Authors

Constance S Harrell Shreckengost¹, Limeng Wan², Alexandra W Reitz³, Alice Lin⁴, Rohan K Dhamsania⁵, Julia Spychalski⁶, J Miller Douglas⁷, Andrea Lane⁸, Dina Amin⁹, Steven Roser¹⁰, David Berkowitz¹¹, Jorge Esteban Foianini¹², Renée Moore¹³, Jithin K Sreedharan¹⁴, Abesh Niroula¹⁵, Randi Smith¹⁶, Onkar V Khullar¹⁷; PTS-COVIDTrach Collaborative

Affiliations

¹ Constance S. Harrell Shreckengost is a resident physician, Department of Surgery, Emory University, Atlanta, Georgia.
² Limeng Wan is a student, Rollins School of Public Health, Emory University.
³ Alexandra W. Reitz is a resident physician, Department of Surgery, Emory University.
⁴ Alice Lin is a student, Rollins School of Public Health, Emory University.
⁵ Rohan K. Dhamsania is a student, Philadelphia College of Osteopathic Medicine, Suwanee, Georgia.
⁶ Julia Spychalski is a student, Rollins School of Public Health, Emory University.
⁷ J. Miller Douglas is a student, Department of Surgery and Rollins School of Public Health, Emory University.
⁸ Andrea Lane is a student, Rollins School of Public Health, Emory University.
⁹ Dina Amin is an assistant professor, Department of Surgery, Emory University and a surgeon, Oral and Maxillofacial Surgery, Grady Memorial Hospital, Atlanta, Georgia.
¹⁰ Steven Roser is a professor, Department of Surgery, Emory University and a surgeon, Oral and Maxillofacial Surgery, Grady Memorial Hospital, Atlanta, Georgia.
¹¹ David Berkowitz is a physician and professor, Department of Medicine, School of Medicine, Emory University.
¹² Jorge Esteban Foianini is a surgeon, Department of Surgery, Clínica Foianini, Bolivia.
¹³ Renée Moore is a professor, Rollins School of Public Health, Emory University.
¹⁴ Jithin K. Sreedharan is general secretary, Indian Association of Respiratory Care, Kochi, India.
¹⁵ Abesh Niroula is a physician, Department of Medicine, School of Medicine, Emory University.
¹⁶ Randi Smith is a surgeon, Department of Surgery, Emory University, a professor, Rollins School of Public Health, Emory University, and a surgeon, Trauma and Surgical Critical Care, Grady Memorial Hospital.
¹⁷ Onkar V. Khullar is a surgeon, Department of Surgery, Emory University.

PMID: 36065019
DOI: 10.4037/ajcc2022337

Abstract

Background: Health care professionals (HCPs) performing tracheostomies in patients with COVID-19 may be at increased risk of infection.

Objective: To evaluate factors underlying HCPs' COVID-19 infection and determine whether tracheostomy providers report increased rates of infection.

Methods: An anonymous international survey examining factors associated with COVID-19 infection was made available November 2020 through July 2021 to HCPs at a convenience sample of hospitals, universities, and professional organizations. Infections reported were compared between HCPs involved in tracheostomy on patients with COVID-19 and HCPs who were not involved.

Results: Of the 361 respondents (from 33 countries), 50% (n = 179) had performed tracheostomies on patients with COVID-19. Performing tracheostomies on patients with COVID-19 was not associated with increased infection in either univariable (P = .06) or multivariable analysis (odds ratio, 1.48; 95% CI, 0.90-2.46; P = .13). Working in a low- or middle-income country (LMIC) was associated with increased infection in both univariable (P < .001) and multivariable analysis (odds ratio, 2.88; CI, 1.50-5.53; P = .001).

Conclusions: Performing tracheostomy was not associated with COVID-19 infection, suggesting that tracheostomies can be safely performed in infected patients with appropriate precautions. However, HCPs in LMICs may face increased infection risk.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

COVID-19* / epidemiology
Health Personnel
Humans
Surveys and Questionnaires
Tracheostomy

Grants and funding

UL1 TR000424/TR/NCATS NIH HHS/United States