PAP therapy increases the risk of transmission of COVID-19

Area of Science:

• Respiratory Medicine
• Infectious Disease Control
• Sleep Medicine

Background:

• Positive airway pressure (PAP) therapy systems are open, posing a risk of COVID-19 transmission through contact, droplet, and airborne routes.
• This risk is comparable to other aerosol-generating procedures like tracheal intubation and cardiopulmonary resuscitation.
• Established guidelines are crucial for managing PAP therapy during the COVID-19 pandemic.

Purpose of the Study:

• To outline medically prudent recommendations for the use of PAP therapy in patients with or suspected of having COVID-19.
• To address the safe application of PAP devices in home settings, sleep clinics, and emergency ventilation scenarios.
• To mitigate the risk of SARS-CoV-2 transmission associated with PAP therapy.

Main Methods:

• Review and synthesis of existing literature and clinical guidelines related to PAP therapy and COVID-19.
• Development of evidence-based recommendations for different patient populations and clinical settings.
• Consideration of PAP devices as potential alternatives to mechanical ventilation in emergencies.

Main Results:

• Specific recommendations are provided for the home use of PAP therapy in asymptomatic, suspected, and confirmed COVID-19 cases.
• Guidelines are detailed for sleep clinics and laboratory activities to prevent viral transmission.
• The emergency application of PAP devices as a substitute for ventilation is discussed with safety considerations.

Conclusions:

• PAP therapy requires careful management to prevent COVID-19 transmission.
• Implementing recommended precautions is essential for patient and healthcare worker safety.
• These guidelines support the continued, safe use of PAP therapy during the pandemic.