Customize your JAMA Network experience by selecting one or more topics from the list below.
Dedicated, impassioned, and exhausted clinicians the world over are collaborating to report the emerging profile of the coronavirus disease 2019 (COVID-19) pandemic. The unparalleled need for intensive care during this period challenges clinicians to bring their best efforts to the bedside, while advising health care leaders on the optimal management of resources to deliver that care in each jurisdiction. A renewed sense of community is avowed among critical care clinicians who share their early observations through traditional and social media, such that learnings from one group of patients can inform the care of the next.
The multicenter report by Grasselli and colleagues in JAMA provides sobering evidence about the burden of critical illness associated with COVID-19 in Lombardy, Italy.1 Of the 1591 predominantly older, male patients with comorbid conditions admitted to the intensive care units (ICUs) of 72 hospitals from February 20 to March 18, 2020, the majority had moderate to severe acute respiratory distress syndrome (ARDS). Overall, of the 88% of patients who underwent endotracheal intubation and mechanical ventilation, the median level of positive end-expiratory pressure (PEEP) was 14 cm H2O. In this cohort, 11% received noninvasive ventilation, exposure to which may have been even more extensive outside the ICU, in original or repurposed high-dependency units for patients with COVID-19, and 27% received early prone ventilation, reflecting the growing reports of using this strategy. By the end of the follow-up period, 26% of patients had died while 58% remained in the ICU. As reported in other series, older patients appeared to have the worst outcomes.1
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Cook DJ, Marshall JC, Fowler RA. Critical Illness in Patients With COVID-19: Mounting an Effective Clinical and Research Response. JAMA. 2020;323(16):1559–1560. doi:10.1001/jama.2020.5775
Create a personal account or sign in to: