Introduction:

Coronavirus disease (COVID-19) is a health emergency and one of the most feared complications is acute respiratory distress syndrome (ARDS) due to its high mortality.

Clinical case:

A 59-year-old male patient with a history of hypertension and smoking, who begins to show symptoms after contact with an asymptomatic carrier of COVID-19 from abroad. The symptoms presented were myalgia, arthralgia, 37.7-degree fever, later 38.4-degree fever, dyspnea, fatigue and odynophagia. He went to the clinic and was hospitalized, being treated with chloroquine, azithromycin and oseltamivir for four days and a sample was taken for COVID-19. The patient presented increased respiratory work, chest radiography was taken with heterogeneous peripheral opacities of both lungs and was corroborated by chest tomography image of polished glass. He presented progressive dyspnea and hypoxemia requiring advanced airway management and was transferred to the metabolic intensive care unit where he was received with mechanical ventilation (MV), requiring sedation, analgesia, muscle relaxant, as well as protective ventilation. Changes of position were made to avoid micro atelectasis. It was obtained by culture of Pseudomonas aeruginosa and Escherichia coli. On the 11th day of the stay in ICU, mechanical ventilation was achieved until weaning, and the patient was discharged from ICU 48 hours later.

Conclusions:

The present case evidences the progress of lung damage by COVID-19 causing respiratory failure requiring mechanical ventilation, where the critical treatment consisted in strengthening the quality dynamics emphasizing ventilatory, hemodynamic and metabolic monitoring.