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- ItemRestrictedOxygen requirements and approaches to respiratory support in patients with COVID-19 in low- and middle-income countries: a WHO O2 CoV2 study(2022-02-09) Rylance, JamieType of research study The study is a prospective cohort (inception) study. 4.2 Problem to be addressed It is estimated that approximately 20% of those affected by COVID-19 require oxygen supportive therapy. Oxygen is an essential medicine and has been listed as such on the WHO Essential Medicines List and Essential Medicines List for children for almost two decades. Still, availability of supplemental medical oxygen in low- and middle-income countries (LMICs) remains a challenge. The COVID-19 pandemic has highlighted, more than ever, the acute need for scale-up of oxygen therapy. WHO has provided an inventory tool to quantify facility-level provision of infrastructure to deliver oxygen therapy. Some data are available from existing studies, however, detailed data on the use of oxygen therapy in LMICs at the patient level remain lacking. The WHO COVID-19 Clinical Characterization and Management Research Group has been developing two research protocols to support the understanding of respiratory support practices and oxygen requirements for the clinical management of COVID-19. The first is an observational study to describe oxygen requirements and respiratory support practices at facilities caring for patients with COVID-19 in LMICs. The second is an interventional platform trial which seeks to compare modalities of respiratory support (continuous positive airway pressure [CPAP] vs high-flow nasal cannula [HFNC], awake prone position). Selection of the most relevant interventions requires an understanding of current practice and expertise in sites that might recruit patients to the trial. Existing studies collect data on oxygen mode of delivery, but do not characterize the type, quantity and duration of each modality’s use at the patient level, to give a better understanding of oxygen therapy modalities in current use in LMICs