Introduction
Coronavirus disease 2019 (COVID-19) remains a major threat to the global population since it was first reported in Wuhan, China. Recent epidemiological studies have shown poor prognosis in patients with COVID-19-related acute respiratory distress syndrome (ARDS).1-3 In fact, the mortality rate of COVID-19 patients with mechanical ventilation is reported to be approximately 40%–60%.3-5 For the effective management of critically ill COVID-19 patients, the appropriate treatment of respiratory failure is crucial.6 Moreover, if the oxygenation worsens despite mechanical ventilation, extracorporeal membrane oxygenation (ECMO) should be considered, as recommended in some guidelines.7,8
Rhesus (Rh) factor is an inherited protein found on the surface of the red blood cells in the body. Since their discovery in the 1940s, it has been considered as a certain type of blood type.9 In Asian countries, < 1% of the population has an Rh-negative blood type;10 therefore, the medical services available for these individuals could be partially limited, e.g., during transfusion and pregnancy.11,12 In particular, ECMO is unreasonable in rare blood type patients because it requires a large number of blood products with the same blood type. Thus, if rare blood type patients develop ARDS due to COVID-19, it is crucial to prioritize lung protection. Here we report the case of an Rh-negative patient with COVID-19-related ARDS who was successfully treated.