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Care for Critically Ill Patients With COVID-19

Educational Objective
Review information on caring for critically ill patients with COVID-19
1 Credit CME

Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections.1 Given how common the disease is becoming, as in prior major severe acute respiratory infection outbreaks—SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), avian influenza A(H7N9), and influenza A(H1N1)pdm09—critical care will be an integral component of the global response to this emerging infection.

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Article Information

Corresponding Author: Srinivas Murthy, MD, CM, MHSc, University of British Columbia, 4500 Oak St, Vancouver, BC V6H 3V4, Canada (srinivas.murthy@cw.bc.ca).

Published Online: March 11, 2020. doi:10.1001/jama.2020.3633

Conflict of Interest Disclosures: Dr Gomersall reported that his department has received funding to develop educational material from Getinge, Draeger Medical, Hamilton Medical, and Fisher & Paykel. No other disclosures were reported.

Additional Contributions: We thank the International Forum of Acute Care Trialists (InFACT) for assistance.

References
1.
Wu  Z , McGoogan  JM .  Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China.   JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648PubMedGoogle Scholar
2.
Wang  D , Hu  B , Hu  C ,  et al.  Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China.   JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585PubMedGoogle Scholar
3.
Chen  H , Guo  J , Wang  C ,  et al.  Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women.   Lancet. Published online February 12, 2020. doi:10.1016/S0140-6736(20)30360-3Google Scholar
4.
Yang  X , Yu  Y , Xu  J ,  et al.  Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China.   Lancet Respir Med. 2020. S2213-2600(20)30079-5PubMedGoogle Scholar
5.
Fan  E , Del Sorbo  L , Goligher  EC ,  et al.  An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome.   Am J Respir Crit Care Med. 2017;195(9):1253-1263.PubMedGoogle ScholarCrossref
6.
Alraddadi  BM , Qushmaq  I , Al-Hameed  FM ,  et al.  Noninvasive ventilation in critically ill patients with the Middle East respiratory syndrome.   Influenza Other Respir Viruses. 2019;13(4):382-390.PubMedGoogle ScholarCrossref
7.
De Backer  D , Dorman  T .  Surviving Sepsis Guidelines: a continuous move toward better care of patients with sepsis.   JAMA. 2017;317(8):807-808.PubMedGoogle ScholarCrossref
8.
COVID-19 case record form. Accessed March 2, 2020. https://isaric.tghn.org/novel-coronavirus/
9.
World Health Organization. Master Protocol: A Multi-center, Adaptive, Randomized Controlled Trial of the Safety and Efficacy of Investigational Therapeutics for the Treatment of COVID-19 in Hospitalized Patients. Published February 24, 2020. Accessed March 2, 2020. https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus/en/
10.
REMAP-CAP: A Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia. Accessed March 3, 2020. http://www.remapcap.org
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