Successful prolonged use of non-invasive ventilation in severe COVID-19 patients: a case series.

BACKGROUND: The Coronavirus disease-19 (COVID-19) primarily affects respiratory system leading to acute hypoxemic respiratory failure. Invasive mechanical ventilation has been a gold standard in the respiratory therapy of patients with acute respiratory distress syndrome (ARDS). It requires advanced ventilators, qualified intensivists and trained intensive care unit (ICU) staff to manage, which is not readily available and of which there has been a perpetual shortage during the current pandemic. Non-invasive ventilation (NIV) is one of the bridging non-invasive respiratory supports to avoid invasive intubation intended to improve oxygenation and ventilation in severe COVID-19 patients where conventional oxygen therapy fails. CASE: The authors report a series of four cases where prolonged NIV was used under expert supervision in patients with severe COVID-19 disease. CONCLUSIONS: This case series showed that NIV can be prolonged successfully under supervision in severe COVID-19 patients that can avoid intubation and its complications.