Respiratory Pathophysiology of Mechanically Ventilated Patients with COVID-19: A Cohort Study
Abstract
Five to twenty percent of hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the ICU, with mortality reported between 26% and 61.5% (1–3). Nearly all ICU patients present with respiratory failure, and up to 88% are managed with invasive mechanical ventilation (1–3). Descriptions of the pathophysiological characteristics of coronavirus disease (COVID-19) respiratory failure are limited. Reports of preserved respiratory system mechanics despite severe hypoxemia in early small series have led some investigators to hypothesize that a significant proportion of COVID-19 respiratory failure is not the typical acute respiratory distress syndrome (ARDS) and warrants alternative management (4, 5). A detailed characterization of COVID-19 respiratory failure and its response to established ARDS therapies is needed before rigorous comparisons of established and new strategies can be contemplated. We describe the respiratory pathophysiology of patients with COVID-19 respiratory failure treated with invasive mechanical ventilation at two tertiary care hospitals in Boston, Massachusetts.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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