Early non-invasive ventilatory treatment for elderly patients with severe SARS-CoV-2 infection, applied by a hospital in the Brazilian Amazon.

Novel coronavirus also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), generated a high worldwide demand for intensive care units and mechanical ventilation equipment, due to the severity of cases of respiratory failure. In the Brazilian state of Amazonas, the infection reached 50% of the national incidence coefficient. In this scenario, we describe the case of a 71-year-old male Amazon's capital citizen with a history of hypertension and obesity who presented a transfer to a hospital facility with worsening fevers, cough, and respiratory distress. Images showed bilateral ground-glass opacities consistent with COVID-19, with more than 50% of involvement. The RT-PCR and IgM / IgG were positive. The patient was treated in intensive care unit (ICU), using medications from the institutional protocol for COVID-19 and, from the beginning until discharge from the ICU, he used non-invasive oxygen therapy with capsule equipment protection for aerosol retention in the hospital environment. After 11 days, the patient was discharged with SatO 2 > 95%, without signs of changes in physiological functions. Early NIV can be considered an alternative for the management of critically ill patients, avoiding complications from hospitalization for longer and the risk of using mechanical ventilation.