inclusion criteria: - sars-cov-2 positive real time - polymerase chain reaction - moderate to severe acute respiratory distress syndrome according to murray classification. - pao2/fio2 less than 200 mmhg. - within 36 hours of orotracheal intubation. - absence of response with previous standard therapy. - willing to participate in the study expressed by patient or responsible caregiver. - not being in other clinical trial.

inclusion criteria: - sars-cov-2 positive real time - polymerase chain reaction - moderate to severe acute respiratory distress syndrome according to murray classification. - pao2/fio2 less than 200 mmhg. - within 36 hours of orotracheal intubation. - absence of response with previous standard therapy. - willing to participate in the study expressed by patient or responsible caregiver. - not being in other clinical trial.