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Most of coronavirus patients who end up on ventilators go on to die, according to several small studies from the U.S., China and Europe.

And many of the patients who continue to live can’t be taken off the mechanical breathing machines.

“It’s very concerning to see how many patients who require ventilation do not make it out of the hospital,” says Dr. Tiffany Osborn, a critical care specialist at Washington University in St. Louis who has been caring for coronavirus patients at Barnes-Jewish Hospital.

That concern is echoed by Negin Hajizadeh, a pulmonary critical care doctor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell on Long Island, N.Y.

“We have had several patients between the hospitals across the Northwell system that have come off the breathing machine,” Hajizadeh says. “But the vast majority are unable to.”

The largest study so far to look at mortality among coronavirus patients on ventilators was done by the Intensive Care National Audit & Research Centre in London.

Of 165 patients admitted to ICUs, 79 (48%) died. Of the 98 patients who received advanced respiratory support—defined as invasive ventilation, BPAP or CPAP via endotracheal tube, or tracheostomy, or extracorporeal respiratory support—66% died.

The numbers from a study of Wuhan, China, are even grimmer. Only 3 of 22 ventilated patients survived.

And a study of 18 ventilated patients in Washington state found that nine were still alive when the study ended, but only six had recovered enough to breathe on their own.

All the early research suggests that once coronavirus patients are placed on a ventilator, they will probably need to stay on it for weeks. And the longer patients remain on a breathing machine, the more likely they are to die.

“We’re not sure how much help ventilators are going to be,” Osborn says. “They may help keep somebody alive in the short term. We’re not sure if it’s going to help keep someone alive in the long term.”