Annals of Intensive Care volume 10 , Article number: Cite this article. Metrics details. Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covidrelated acute respiratory distress syndrome ARDS.
The primary endpoint was the number of day 28 ventilator-free days VFD. Patients who died before d28 were considered as having 0 VFD. COVID can have different clinical presentations, but respiratory symptoms predominate especially in patients requiring intensive care unit ICU admission [ 1 ].
Respiratory symptoms mainly affect adults over 50 years of age, predominantly males with cardiovascular comorbidities [ 1 , 2 ]. The respiratory features are characterized by severe hypoxemia, radiological ground glass opacities and especially crazy paving. Despite expert recommendations that were implemented quickly [ 6 ], the management was not based on high levels of evidence during the West European first wave MarchโApril The treatments applied varied from one country to another and from one center to another.
Frantic rush towards the most efficient antiviral therapy has been ongoing since the epidemic started. The last two were already on the market with an acceptable safety profile.
However, they have not been used widely in critically ill patients and some potential unknown side effects may exist. We conducted an observational international multicentre study assessing patients suffering from moderate-to-severe COVIDrelated ARDS to detect a possible signal of efficacy or deleterious effects of these antiviral therapies. Herein, we report the outcomes of these COVID patients admitted to ICU and requiring invasive mechanical ventilation according to the chosen therapeutic strategy among several antivirals or standard of care.
