CPAP Therapy May Help Treat Early-Stage COVID-19

By Dr. Frank Yap, MD

Key Takeaways

  • CPAP use during early hospital admission can help decrease disease progression and respiratory failure in patients diagnosed with COVID-19.
  • Researchers have established ways to safely modify CPAP machines for patients to use as ventilators, decreasing the number of patients that end up needing mechanical ventilation.
According to a study out of the U.K., Continuous Positive Airway Pressure (CPAP) is emerging as a lifesaving device for those in the early stages of COVID-19. 



Researchers from Lancaster University found that in 206 patients seeking care at the Royal Albert Edward Infirmary in Wigan, England, when CPAP treatment was initiated within four days of hospital admission, survival probability increased to over 73%.

Despite this being a pilot study with a small sample size, it shows CPAP machines can make a significant impact when it comes to reducing the severity of COVID-19.

“CPAP acts like an air compressor that uses pressure to help keep the airway open and can assist with air exchange,” Michelle Cao, MD, a pulmonologist and sleep specialist with Stanford Health Care in California, who was not involved in the study, tells Verywell. “I would love to see more studies like this, especially during this next COVID-19 surge. During a ventilator shortage, CPAP could be a good bridge to help with breathing.”

How Can CPAP Help With COVID-19?

According to the study, during the early phases of the pandemic, when medical professionals were still trying to figure out how to treat COVID-19 patients, early intubation and mechanical ventilation were used for patients experiencing respiratory failure. With time, doctors discovered that ventilation was associated with poor outcomes, so they considered non-invasive ventilation, including CPAP, as an alternative to early intubation. 

To test the efficacy of CPAC machines in COVID-19 treatment, a team of researchers at New York’s Tandon School of Engineering were able to use readily available materials, such as microbial filtration, to modify the way the machines function. Essentially, they trapped the virus and prevented air contamination.

Researchers found that if used during the early days of hospital admission, CPAP machines can help treat initial stages of respiratory failure, and decrease the number of people requiring the use of a mechanical ventilator.

The low cost of a CPAP machine compared to a mechanical ventilator also makes it a welcome alternative for hospital systems. Because they are non-invasive and are already available in the majority of hospitals, the use of CPAP machines could help decrease the burden for many healthcare facilities in less developed countries.

What Is a CPAP Machine: A CPAP machine is designed to use positive airway pressure to keep the airway open during sleep reducing instances of sleep apnea events and snoring while improving respiration. According to the Sleep Foundation, CPAP is most commonly prescribed to people with obstructive sleep apnea. Users wear a face mask and receive pressurized air from a connected hose. It is considered the gold standard treatment for those diagnosed with sleep disorders.

Risks of Using CPAP on COVID-19 Patients

Researchers from Lancaster University pointed out that study results showed that CPAP use in patients with a longer hospital stay, which was defined as seven or more days, was associated with an increased risk of death. This is because of disease progression leading to more advanced respiratory failure, which is not treatable via CPAP machine.

“One risk of CPAP use in COVID-19 positive patients is providers not recognizing how fast patients can decompensate,” Cao says. “Providers need to be ready for clinical deterioration.”

Temple Health states that CPAP use at home can initiate the spread of the coronavirus through droplets from leaks around the mask, or from the exhalation port. It is important to isolate yourself from others if you do become infected, but don’t discontinue CPAP treatment.

Donating CPAP Machines for Hospital Use

Survivors for Good, a California non-profit corporation, established the Ventilator SOS project, which helps supply hospitals with donated CPAP machines along with the necessary equipment to modify them into special-use ventilators during the pandemic.

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