Patients with acute respiratory distress syndrome due to pandemic Coronavirus disease 2019 (COVID-19)

We report on a case study of patients with Coronavirus disease 2019 (COVID-19). Evaluation of factors predicting outcome in patients with COVID-19 are very important. Both patients developed respiratory failure complicated by acute respiratory distress syndrome. Patients were intubated and invasively ventilated, underwent prone positioning and careful ventilation according to criteria for acute respiratory distress syndrome. In addition, biomarkers were daily evaluated including C-reactive protein, d-dimer and high-sensitive troponin T. Although treatment did not differ between patients, one patient survived whereas the other one died. The patient who survived had a faster onset of invasive ventilation with prone positioning, a lower maximal level of C-reactive protein and a lower value of high-sensitive troponin T. The use of mechanical ventilation in combination with a high PEEP and an early start of prone positioning in patients with severe ARDS may be beneficial. The values of C-reactive protein and troponin T levels seems to be predictive for the clinical course