Non-Invasive Ventilation in COVID-19 Patients: A Debate to Continue

The use of Non-Invasive Ventilation (NIV) in patients with acute hypoxemic respiratory failure and specifically in Corona Virus Disease 2019 (COVID-19) that causes by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a matter for discussion since the current COVID 19 pandemic started. The limited available data led to conflicting opinions and variable recommendations and suggestions by the different health care professional bodies. Trends toward early intubation and avoiding NIV justified by the rapid deterioration of patients and the risk of disease transmission to the health care workers were prevalent mainly in the early stages of the pandemic. The limited available medical resources to provide invasive ventilation and subsequent anecdotal evidence suggestive of NIV success in patients with COVID 19 respiratory failure led to a change in the practice in different medical institutions around the world. Despite the absence of strong evidence, NIV probably has a role in the management of COVID 19 respiratory failure in a selected group of patients especially in the early stages of the disease via Continuous Positive Airway Pressure. Close monitoring and strict infection control precautions are required whilst providing NIV to avoid any possible complications.