RECOVERY Respiratory Support: Respiratory Strategies in patients with coronavirus COVID-19 – CPAP, high-flow nasal oxygen, and standard care

In adult patients with known or suspected COVID-19, does the use of Continuous Positive Airway Pressure (CPAP) or high-flow nasal oxygen (HFNO), compared with standard care reduce mortality or need for tracheal intubation?

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN16912075

Enrollment

4002

Registered

2020-04-06

Start date

2020-04-06

Completion date

Unknown

Last updated

2026-06-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Respiratory failure in patients with known or suspected COVID-19 (SARS-CoV-2 infection) Respiratory COVID-19 (SARS-CoV-2 infection)

Interventions

Patients will be randomised in a 1:1:1 ratio to: Arm 1: Continuous positive airway pressure (CPAP), administered according to local protocol/guidelines. Administration will be left to clinical discret

Eligibility

Sex/Gender

All

Age

18 Years to 110 Years

Inclusion criteria

Inclusion criteria: Current participant inclusion criteria as of 04/05/2021: 1. Adults =18 years 2. Hospital inpatient with suspected or proven COVID-19 3. FiO2 =0.4 and SpO2 =94% 4. Plan for escalation to intubation if needed Previous participant inclusion criteria: 1. Adults = 18 years 2. Admitted to hospital with suspected or proven COVID-19 3. On 40% oxygen (or greater) with SpO2 <94% 4. Plan for escalation to intubation if needed

Exclusion criteria

Exclusion criteria: Current participant exclusion criteria as of 04/05/2021: 1. Planned intubation and mechanical ventilation imminent within 1 hour 2. Known or clinically apparent pregnancy 3. Any absolute contraindication to CPAP or HFNO 4. Decision not to intubate due to ceiling of treatment or withdrawal of treatment anticipated 5. Equipment for both CPAP and HFNO not available Previous participant exclusion criteria: 1. Planned intubation and mechanical ventilation imminent within 1 hour 2. Known or clinically apparent pregnancy 3. Any absolute contraindication to CPAP or HFNO 4. Decision not to intubate due to ceiling of treatment or withdrawal of care anticipated 5. Equipment for both CPAP and HFNO not available

Design outcomes

Primary

Measure	Time frame
Composite outcome comprising tracheal intubation or mortality within 30 days. Mortality will be reported from hospital records up until discharge and tracked after discharge. Intubation will be obtained from hospital data.	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 04/05/2021: All outcome measures are assessed at up to 30-days or hospital discharge, whichever is later, and obtained from hospital records unless otherwise specified. 1. Intubation rate 2. Time to intubation 3. Time to death (mortality), obtained from hospital record or other source 4. Mortality in critical care (level 2/3) 5. Mortality during hospital stay 6. Mortality at 30 days, obtained from hospital record or other source 7. Length of stay in critical care (level 2/3) 8. Length of stay in hospital 9. Duration of invasive ventilation 10. Admission to ICU Previous secondary outcome measures: All outcome measures are assessed at up to 30-days or hospital discharge, whichever is later, and obtained from hospital records unless otherwise specified. 1. Intubation rate 2. Time to intubation 3. Time to death (mortality), obtained from hospital record or other source 4. Mortality in critical care (level 2/3) 5. Mortality during hospital stay 6. Mortality at 30 days, obtained from hospital record or other source 7. Length of stay in critical care (level 2/3) 8. Length of stay in hospital	—

Measure

Time frame

Current secondary outcome measures as of 04/05/2021: All outcome measures are assessed at up to 30-days or hospital discharge, whichever is later, and obtained from hospital records unless otherwise specified. 1. Intubation rate 2. Time to intubation 3. Time to death (mortality), obtained from hospital record or other source 4. Mortality in critical care (level 2/3) 5. Mortality during hospital stay 6. Mortality at 30 days, obtained from hospital record or other source 7. Length of stay in critical care (level 2/3) 8. Length of stay in hospital 9. Duration of invasive ventilation 10. Admission to ICU Previous secondary outcome measures: All outcome measures are assessed at up to 30-days or hospital discharge, whichever is later, and obtained from hospital records unless otherwise specified. 1. Intubation rate 2. Time to intubation 3. Time to death (mortality), obtained from hospital record or other source 4. Mortality in critical care (level 2/3) 5. Mortality during hospital stay 6. Mortality at 30 days, obtained from hospital record or other source 7. Length of stay in critical care (level 2/3) 8. Length of stay in hospital

—

Countries

England, Northern Ireland, Scotland, United Kingdom, Wales

Contacts

Public ContactKeith Couper

k.couper@warwick.ac.uk+442476151179

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Jun 27, 2026