Abstract
Background Non-invasive respiratory support strategies, such as high-flow nasal cannula therapy and non-invasive ventilation, were widely employed during the coronavirus disease 2019 (COVID-19) pandemic, yet their comparative effectiveness remains uncertain. Objective To compare the effects of high-flow nasal cannula therapy, non-invasive ventilation, and conventional oxygen therapy on intubation rates and hospital mortality in adults with COVID-19-related acute respiratory failure. Methods A systematic review and meta-analysis was conducted following PRISMA and Cochrane guidelines, with searches performed in nine databases for

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