Zhang Q, Shen J, Chen L, et al. - Researchers here reported the case series of critically ill patients with coronavirus disease 2019 (COVID-19) receiving invasive mechanical ventilation (IMV) in Wuhan. In addition, they discussed the timing of IMV in these patients. Retrospectively reviewing data of 657 patients admitted to the emergency intensive care unit of Zhongnan Hospital and isolated isolation wards of Wuhan Union Hospital from January 1 to March 10, 2020, they included all medical records of 40 COVID-19 patients who required IMV. Among these 40 patients requiring IMV, 31 died, and 9 survived and were discharged. The median age was 70 years (interquartile range [IQR], 62–76 years), and relative to survivors, nonsurvivors were older. Findings suggest the possible benefit of performing early initial intubation after NIV/HFNC for reducing mortality for critically ill patients meeting IMV indication. They suggest considering APACHE II and PSI scores as possibly valuable for physicians in decision making concerning timing of intubation for curbing subsequent mortality. Per observations, when the time interval from NIV/HFNC to intubation was less than 50 hours (about 2 calendar days), together with Acute Physiology and Chronic Health Evaluation II (APACHE II) score of less than 10 or pneumonia severity index (PSI) score of less than 100, reduction in mortality upto 60% or less can be achieved.