In our ‘real-world’ observational study, 15 out of 16 patients with severe COVID-19 infection requiring FiO2 > 0.6 who were deemed unsuitable for invasive ventilation and received CPAP therapy, did not survive (93.75% mortality). This was similar to the 92.73% mortality in the control group. Both groups of patients were similar, except for a significant age difference in favour of the CPAP group. With age being a strong predictor of mortality in COVID-19 infection, we would have expected the results to favour the CPAP group. Despite this, a similar percentage of patients survived in this group as in the CPAP group. The high mortality raises doubts about the effectiveness of this modality of treatment in patients who are not suitable for invasive ventilation, even if one were to disregard the oxygen group completely. It is possible that CPAP is not actually beneficial in this specific group of patients but would definitely require further large-scale studies to confirm this.