Image of Bruce Polsky, M.D.; Image credit: NYU Langone Health

Being on a ventilator appears to protect nursing home residents from COVID-19, researchers say.

In an unusual pre-vaccine study across three nursing homes, no COVID-19-related case clusters or deaths could be found among residents who were regularly on ventilators.

The study included 93 chronically ventilated and about 1,100 non-ventilated residents in three Long Island, NY, nursing homes. Investigators examined mortality rates, respiratory illness, and COVID-19 PCR test results among residents and staff during COVID-19 outbreaks as of mid-March 2020.

The chronically ventilated residents had a death rate similar to rates of ventilated residents one year prior (9 of 93 in 2020, versus 8 of 100 in 2019). Deaths among non-ventilated residents, meanwhile, greatly increased (214 of 1,151 in 2020, versus 55 of 1,189 in 2019). 

In fact, none of the ventilated resident deaths were clinically judged to be COVID-19-related, and there were no clusters of COVID-19 cases among these residents, wrote Bruce Polsky, M.D., of NYU Long Island School of Medicine. This was despite illness and the evidence of COVID-19 infection among staff who worked in both the ventilator and non-ventilator units, and facilitywide outbreaks among staff and non-ventilated residents that occurred during the study period.

Ventilators may provide a protective environment that prevents the SARS-CoV-2 virus from entering the lower respiratory tract and gaining a foothold, Polsky and colleagues surmised. Although care providers should continue to wean residents off ventilators when warranted, “until this matter is further studied we suggest that the potential
risk for COVID-19 infection versus the benefit of ventilator liberation must still be considered,” they said.

“The mechanics of chronic ventilation appear to protect chronically ventilated patients from COVID-19 disease,” the authors concluded.

Participating facilities used the same ventilator brand. The study was published in JAMDA.