Non-invasive respiratory support for patients with novel coronavirus pneumonia:clinical efficacy and reduction in risk of infection transmission

Introduction Pneumonia caused by a novel coronavirus known as 2019 novel coronavirus disease(COVID-19)[1]appeared in Wuhan,China in December 2019,and approximately 15%to 30%of patients developed acute respiratory distress syndrome within a short period of time.[2,3]To reduce respiratory symptoms and improve prognosis,respiratory support is the most important means of life support,[1]and non-invasive respiratory support systems,[2]including various conventional oxygen therapies,non-invasive positive pressure ventilation(NPPV),and high-flow nasal cannula(HFNC),are most commonly used.However,their efficacy and safety remain unclear,and whether they increase the risk of aerosol dispersion and disease transmission is particularly controversial.[4,5]Given that there are many similarities between COVID-19 pneumonia and severe acute respiratory syndrome(SARS)and Middle East respiratory syndrome(MERS),[6]this study primarily discusses clinical indications and provides details regarding the prevention of nosocomial infections during NPPV and HFNC treatment of COVID-19 pneumonia based on previous clinical data on the use of these two therapies for SARS and MERS and our experience with the treatment of COVID-19 pneumonia.