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Coronavirus (COVID-19)

Severe COVID-19 Infections—Knowledge Gained and Remaining Questions

Educational Objective
To understand the current knowledge base around severe COVID-19 infections and what still needs additional research

1 Credit CME

JAMA Internal Medicine

Published Online: September 18, 2020

Editorial

Article Information and Disclosures

Lieuwe D. J. Bos, MD, PhD¹;

Daniel Brodie, MD^2,3;

Carolyn S. Calfee, MD, MAS^4,5

Author Affiliations

¹Intensive Care and Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
²Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
³Center for Acute Respiratory Failure, New York-Presbyterian Hospital, New York, New York
⁴Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco
⁵Department of Anesthesia and Perioperative Care, University of California, San Francisco

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Patients with acute respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have overwhelmed critical care capacity in some cities and countries. The mortality of patients who require critical care is high but varies widely among hospitals.¹ Despite a rapidly increasing understanding of the pathogenesis of coronavirus disease 2019 (COVID-19), uncertainty remains about the reasons that some patients develop respiratory failure and others have no to minimal symptoms, as well as about the optimal management of patients with severe COVID-19 disease.² We review the evidence for the management of patients with the acute respiratory distress syndrome (ARDS) that may apply to patients with severe COVID-19, what has been learned about treatment of these patients, and the gaps in knowledge that remain.

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Article Information

Corresponding Author: Carolyn S. Calfee, MD, MAS, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, 505 Parnassus Ave, Box 0111, San Francisco, CA 94143-0111 (carolyn.calfee@ucsf.edu).

Published Online: September 18, 2020. doi:10.1001/jamainternmed.2020.6047

Conflict of Interest Disclosures: Dr Bos reports receiving research support from Health Holland, the Dutch Lung Foundation through the Dirkje Postma Award, the Innovative Medicine Initiative, and the Amsterdam UMC fellowship. Dr Brodie reports receiving research support from ALung Technologies and personal fees from serving on the medical advisory boards for Baxter, Abiomed, and Xenios; he serves in an unpaid position on the medical advisory board for Hemovent. Dr Calfee reports receiving research support from the National Institutes of Health, Roche/Genentech, and Bayer; she has served as a consultant to Roche/Genentech, Bayer, Quark Pharmaceuticals, CSL Behring, Vasoume, and Gen1e Life Sciences.

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.