Lung Compliance in a Case Series of Four COVID-19 Patients at a Rural Institution

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic has generated a plethora of scientific articles. One interesting aspect of the virus is the binary phenotypic presentation in patients. While patients might meet the Berlin criteria for acute respiratory distress syndrome (ARDS), not all patients experience the same decrease in lung compliance as typically seen with ARDS. We have observed patients meeting ARDS criteria with higher lung compliance as measured through peak pressures at our institution. This phenotype difference is important with regard to how the patients are managed. Lower positive end-expiratory pressure (PEEP) and higher tidal volumes can be used in this phenotype.