Absence of COVID-19 Disease Among Chronically Ventilated Nursing Home Patients.

PCR testing was not widely available early in the outbreak, so mild or missed infections cannot be excluded. One ventilated patient had a positive test, so the finding is not an absolute absence of infection. Staff on ventilator units developed illness, so exposure was present and infection control may not have fully prevented staff transmission. The study did not randomly assign ventilation; it compared existing groups, so differences between units, patients, or care practices may explain the findings. All 3 facilities used the same ventilator model, so the results may not apply to other ventilator systems. Facility C death dates were not available, so it was not included in some mortality models. The authors say additional studies are needed to confirm the findings and clarify ventilator-specific outcomes.

Do not conclude that mechanical ventilation protects patients from COVID-19. This was an observational report of 3 nursing homes, and infected staff plus other facility differences could explain the pattern.