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Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC). Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index. 53 patients were included. Forty-four of them were i

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