Respiratory Pathophysiology of Mechanically Ventilated COVID-19 Patients

Background and objectives Coronavirus disease 2019 (COVID-19) is mainly a disease of the respiratory system that can lead to acute respiratory distress syndrome (ARDS). The pathophysiology of COVID-19 ARDS and consequently its management is a disputable subject. Early COVID-19 investigators hypothesized that the pathogenesis of COVID-19 ARDS is different from the usual ARDS. The aim of this study was to describe the lung mechanics in mechanically ventilated COVID-19 patients with ARDS. Methodology An observational retrospective cohort study was conducted on adult COVID-19 patients with ARDS who needed mechanical ventilation in the ICU of Ohoud Hospital, Madinah, KSA, from June to September 2020. Data were collected from the patients' medical charts and electronic medical records and analyzed using Statistical Package for the Social Sciences (SPSS) software package version 22 (IBM Corp., Armonk, NY) for descriptive statistical analysis. Measurements and main results A total of 52 patients were analyzed: on intubation, the median positive end-expiratory pressure (PEEP) was 10 cm H₂O (IQR, 2.3-16), the median plateau pressure was 27 cm H₂O (IQR, 12-40), and the median driving pressure was 17 cm H₂O (IQR, 3-30). The median static compliance of the respiratory system was 24.7 mL/cm H₂O (IQR, 12.8-153.3). 59.5% had severe ARDS (the PaO₂/FiO₂ ratio was less than 100 mmHg), and 33% had moderate ARDS (the PaO₂/FiO₂ ratio ranged from 100 to 200 mmHg). Conclusion Our results suggest that the lung mechanics in COVID-19 ARDS patients who need mechanical ventilation do not differ from non-COVID-19 patients.