Figure 1 The optimized procedures of tracheostomy step by step for Covid-19 patients.

Each tracheostomy was evaluated by intensive care physicians and otolaryngologists before operations. The patients have been confirmed SARS-CoV-2 infection, and accepted an orotracheal intubation for more than two weeks, and not suitable for percutaneous tracheostomy. Their condition is basically stable, and the blood oxygen saturation is maintained above 90%.

Full author list

Yi Zhong, M.D., Hongjun Xiao, M.D. Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Mark A. Varvares, M.D. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts

Drs. M. A. Varvares, H.J. Xiao, Y. Zhong, X.M. Zhang and F.C. Cai contributed equally to this letter.