Researchers examined if there has been an improvement in clinical outcomes of hospitalized patients with COVID-19–related acute hypoxemic respiratory failure in correlation with receiving either continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO), compared with conventional oxygen therapy.

• Randomized clinical trial of 1,273 hospitalized adults with COVID-19–related acute hypoxemic respiratory failure.

• 36% of the patients in the CPAP group vs 44% in the conventional oxygen therapy group experienced the composite primary outcome of tracheal intubation or mortality within 30 days, a difference that was statistically significant; the outcome occurred in 44% in the HFNO group vs 45% in the conventional oxygen therapy group, a difference that was not significantly different.

• Overall findings suggest an occurrence of significant reduction in the risk of tracheal intubation or mortality in correlation with initial strategy of CPAP vs conventional oxygen therapy, but there appears no significant difference between an initial strategy of HFNO vs conventional oxygen therapy.