A Case Series of COVID-19 ICU Patients who Improved without Requiring Intubation

The SARS-CoV-2 virus, more commonly known as coronavirus 2019 (COVID-19), is a novel respiratory virus that was first recognized in China and has now spread across the world. The outbreak of the “ Coronavirus Disease 2019” (COVID-19) started in December 2019 and quickly became a sweeping and unprecedented challenge to different stakeholders in mainland China. Although the epidemic of COVID-19 is not yet over, it has already outpaced the previous severe acute respiratory syndrome (SARS) in 2003 and Middle East respiratory syndrome (MERS) in 2012. Approximately 3.2% of patients with COVID-19 required intubation and invasive ventilation at some point in the disease course. Providing best practices regarding intubation and ventilation for an overwhelming number of patients with COVID-19 amid an enhanced risk of cross-infection is a daunting undertaking. By putting patients on ventilators comes with risks, too, including infection and unintentional damage to the lungs. Very often, patients require heavy sedatives to paralyze them so doctors can get the breathing tube into the patients' windpipe. That procedure, called intubation, also carries the risk of infection and lung complications, and can expose health care workers to virus-filled respiratory droplets. This is a case series that explains the clinical outcomes of COVID-19 patients who have required high amounts of supplemental oxygen, but were able to improve without intubation.