The Effects of Intravenous Diuretics on the use of Mechanical Ventilation on Covid 19 Patients requiring Supplemental Oxygen: A Propensity Score Matched Observational Study

Author(s): Kwang Jin Choi, Rachel Baccile, Jackie Soo MPH, David Meltzer

Objective: To examine the effects of intravenous diuresis on the use of mechanical ventilation in Covid patients requiring supplemental oxygen. Methods: 983 hospitalized adult patients with Covid 19 infections needing supplemental oxygen between March 2020 to February 2022 were included in the study. The primary outcome was the use of mechanical ventilation. We compared the outcome in patients who were exposed to intravenous furosemide before mechanical ventilation to those patients who were not exposed to intravenous furosemide during hospitalization using propensity-score matching analysis.

Results: Among the 983 patients who received intravenous furosemide, 186 (18.9%) patients required mechanical ventilation. Of the 491 patients who did not receive intravenous furosemide during hospitalization, 102 (20.7%) required mechanical ventilation. There was a significant negative association between patients exposed to intravenous furosemide who required mechanical ventilation than those who did not receive intravenous furosemide who required mechanical ventilation. (Odds Ratio of 0.37; 95% Confidence Interval 0.21 to 0.66; P value < 0.01)

Conclusions: In this retrospective cohort study involving a moderately sized sample of hospitalized Covid 19 patients who required supplemental oxygen, intravenous diuresis was significantly associated with lower use of mechanical ventilation compared to those that were not exposed to intravenous diuresis (adjusted Odds Ratio 0.37; 95% Confidence Interval 0.21 to 0.66; P value < 0.01).