Management of severe / critical cases of COVID-19 with non-invasive or mechanical ventilation: based on information as at 1st June 2020

Severe and critical infection of SARS-CoV-2 is characterized by Acute Respiratory Distress Syndrome. The use of ventilators (non-invasive and mechanical), to deliver oxygen in cases of severe and critical COVID-19 has been championed, as the mainstay of treatment for severe and critical cases of COVID-19 though its use remains controversial. Thus far, among the 5% of COVID-19 patients who require treatment in an ICU [4], about 88% of them have been placed on mechanical ventilation due to the occurrence of severe hypoxemia[5] that progresses into acute hypoxemic respiratory failure (ARDS). Current evidence suggests that once ARDS develops in COVID-19 patients, the prognosis is far worse than ARDS due to other causes, with a fatality rate greater even than ARDS due to sudden acute respiratory syndrome (SARS) or Middle East Respiratory Syndrome (MERS) [2].