Among patients from group A with CAP nine (n = 9) died; six patients were admitted to the ICU and three were not admitted to the ICU due to relatives' denial. Mean age of patients not admitted to ICU was 80 years; the first two patients had a case-history of stroke and chronic heart failure; the third patient had a case-history of lung cancer. All three died from severe sepsis and multiorgan dysfunction syndrome (MODS). Mean age of patients admitted to ICU was 70 years; two patients had a case-history of aortic valve stenosis; two patients were under chronic intake of receiving corticosteroids; the fifth patient suffered from end-stage renal disease; and the sixth patient was suffering from hepatic failure due to alcohol intake. All six patients died from severe sepsis and multiorgan dysfunction syndrome (MODS). All patients in the ICU accomplished the clinical and radiological criteria for acute respiratory distress syndrome (ARDS) and were ventilated with the strategy of low tidal volume ventilation, according to current guidelines [30] , with volume limited mode ventilation, low tidal volumes (about 6 ml/kg ideal body weight), a maximum of 25-30 breaths per minute, high positive end-expiratory pressure (PEEP 10 cmH 2 O) and a goal plateau airway pressure < 30 cmH 2 O. Among patients admitted in the ICU, two died on the second day post-admission; one died on the third day post-admission; one on the seventh day post-admission; one the eighth day postadmission; and one on the twentieth day post admission.