Timing of tracheostomy
Our data demonstrated that patients that underwent early tracheostomy had shorter subsequent lengths of hospital stay. There are a variety of clinical factors including disease severity, medical therapy and emerging evidence about viral load and infectivity, which will have influenced decisions regarding timing of tracheostomy. The distinct categorisation of patients into early and late tracheostomies, even when outcomes are adjusted for patient factors, may be too simplistic. However, our data suggests that there is no need to delay tracheostomy insertion in the expectation that this will improve patient outcomes. Indeed, there is evidence that delaying tracheostomy insertion may lead to long-term complications such as tracheal stenosis.17