糖心vlog

To the Editor We read with much interest the article of Kwak et al,¹ titled 鈥淓arly Outcomes From Early Tracheostomy for Patients With COVID-19.鈥� The authors' results challenged recommendations to delay or avoid tracheostomy in patients with coronavirus disease 2019 (COVID-19) categorically. However, we would like to pay attention to several aspects according to the tracheostomy in patients with COVID-19. Percutaneous and open tracheostomy have a comparable level of safety for medical staff and patients. However, each of these methods has considerable limitations.^1-3 Unfortunately, the authors did not present any differences in the results depending on the tracheostomy method used.

Speaking about reducing the patient's decannulation time after tracheostomy, according to Hern谩ndez et al,⁴ basing the decision to decannulate on suctioning frequency plus continuous high-flow oxygen therapy reduced the time to decannulation. In combination with the results of Kwak et al,¹ it could improve the treatment outcomes of patients with COVID-19.

However, the timing of tracheostomy is controversial owing to the infectivity of patients with COVID-19. Available evidence suggests that viral shedding is maximal in the first week of infection, although positive RNA findings on swabs may persist for considerably longer.²

Corresponding Author: Dmitry Tretiakow, MD, PhD, Department of Otolaryngology, Medical University of Gdansk, Smoluchowskiego str. 17, 80-214 Gdansk, Poland (d.tret@gumed.edu.pl).

Published Online: March 25, 2021. doi:10.1001/jamaoto.2021.0178

Conflict of Interest Disclosures: None reported.