Background: Volatile
anesthetics were used as
sedative agents in
COVID-19 (
Coronavirus Disease 2019) invasively ventilated patients for their potentially beneficial pharmacological effects and due to the temporary shortages of intravenous agents during the pandemic crisis. Methods: Online databases (PubMed, EMBASE, The Cochrane Central Register of Controlled Trial) and the “clinicaltrials.gov” website were searched for studies reporting the use of
isoflurane,
sevoflurane or
desflurane. Results: We identified three manuscripts describing the beneficial effects of
isoflurane on 41
COVID-19 patients with
acute respiratory distress syndrome (ARDS) in Germany (n = 2) and in the USA (n = 1), in terms of reduction in the use of
opioids and other
sedatives. We also found a case report of two patients with transient
nephrogenic diabetes insipidus, which started after 6 and 8 days of
sevoflurane sedation. We identified two randomized controlled trials (RCTs; 92 patients overall), two observational studies (238 patients) on the use of volatile
anesthetics in
COVID-19 patients that were completed but not yet published, and one RCT interrupted for a low recruitment ratio (19 patients) and thus not published. We also identified five ongoing RCTs on the use of inhaled sedation in ARDS, which are also likely to be recruiting
COVID-19 patients and which have currently enrolled a total of >1643 patients. Conclusion:
Isoflurane was the most frequently used volatile agent in
COVID-19 patients and allowed a reduction in the use of other
sedative and
analgesic drugs. Randomized evidence is building up and will be useful to confirm or challenge these findings.