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COVID-19 critical illness: A data-driven review

Annual Review of Medicine September 14, 2021

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Research Areas

PAIR Center Research Team


The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges in critical care medicine, including extreme demand for intensive care unit (ICU) resources and rapidly evolving understanding of a novel disease. Up to one-third of hospitalized patients with COVID-19 experience critical illness. The most common form of organ failure in COVID-19 critical illness is acute hypoxemic respiratory failure, which clinically presents as acute respiratory distress syndrome (ARDS) in three-quarters of ICU patients. Noninvasive respiratory support modalities are being used with increasing frequency given their potential to reduce the need for intubation. Determining optimal patient selection for and timing of intubation remains a challenge. Management of mechanically ventilated patients with COVID-19 largely mirrors that of non-COVID-19 ARDS. Organ failure is common and portends a poor prognosis. Mortality rates have improved over the course of the pandemic, likely owing to increasing disease familiarity, data-driven pharmacologics, and improved adherence to evidence-based critical care.

As of April 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 150 million cases of coronavirus disease 2019 (COVID-19) and over 3 million deaths worldwide (1). The COVID-19 pandemic has been characterized by local surges of infection accompanied by tremendous demand for hospital and intensive care unit (ICU) resources. In parallel with these uniquely challenging conditions, knowledge around the treatment of this novel disease has accelerated rapidly. Here we review the literature surrounding the management of critically ill patients with COVID-19.


National Heart, Lung, and Bloo Insitiute (NHLBI)
Agency for Healthcare Research and Quality (AHRQ)