Intubation and ventilation may not be the right choice for some COVID-19 patients with severe illness, and may actually cause lung injury, some critical care doctors have found.

The problem is that the virus’s presentation does not always follow the typical path of acute respiratory distress syndrome, instead appearing more like high-altitude pulmonary edema in some patients, says Luciano Gattinoni, M.D., from the University of Göttingen, Germany, and colleagues. 

Gattinoni and other doctors in areas hard-hit by the coronavirus argue that it may be best not to follow acute respiratory distress syndrome protocol in these cases. The patients present with dangerously low blood oxygen levels (hypoxemia), but without other signs that typically accompany this condition, such as confusion. For these patients, noninvasive respiratory support such as a CPAP machine may be the best initial choice, they conclude.

In other coronavirus news:

Simple coronavirus immunity tests could help get care providers back to work: Commercial labs are rushing to produce serologic tests for COVID-19, with the aim of identifying those who are now immune to the virus, and putting them back to work. Serologic tests determine whether a person has antibodies to a virus, and is therefore presumably immune. “If a test can show that a health worker has already had COVID-19 … they can return to work without fear of infection,” sources propose in a new report in The Lancet.

COPD patients have higher levels of coronavirus ‘entry point’ enzyme in lungs: Patients with COPD and smokers have higher levels of ACE-2 in their airways. This enzyme is considered to be an entry point for SARS-CoV-2 (the virus which causes COVID-19) and excess amounts may put individuals at increased risk of developing severe infections, according to a study published in the European Respiratory Journal. The researchers warn that patients with COPD should be advised to “strictly abide” by social distancing protocols and practice proper hand hygiene to prevent infection.

DEA takes steps to increase production of ventilator meds during shortage: The United States Drug Enforcement Agency is taking steps to ramp up manufacturing of medications needed to safely ventilate COVID-19 patients, according to STAT. Hospital order fulfillment rates for the drugs have fallen in recent weeks, and the agency is increasing production quotas by 15% for several controlled substances, including fentanyl, morphine, hydromorphone, codeine, ephedrine, and pseudoephedrine, and increasing imports for others, the news outlet reported.