Pulmozyme to Improve COVID-19 ARDS Outcomes

Inclusion Criteria: * ICU admission for pneumonia complicated by respiratory failure. * RT-PCR (or equivalent) confirmed COVID-19 infection. * Intubated and on mechanical ventilation within 120 hours of initiation of mechanical ventilation. * Age ≥ 3 years of age. Exclusion Criteria: * Allergy or known intolerance to Pulmozyme or Chinese Hamster Ovary cell products * History of moderate to severe asthma, cystic fibrosis, or severe COPD (baseline FEV1 ≤ 40% predicted) * Active malignancy other than basal cell melanoma or in situ breast cancer * Unstable angina * Chronic liver disease as judged by the investigator that would pose significant risk to participation * Chronic renal disease as judged by the investigator that would pose significant risk to participation * Inability to obtain informed consent from patient or legally authorized representative (LAR) * Pregnant or breastfeeding Use of extracorporeal membrane oxygenation (ECMO) * Prisoner status * Concurrent treatment with other inhaled investigational agent for COVID-19\*\* * Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest) * Moribund patient not expected to survive 24 hours * Active hemoptysis