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Intensive Care Unit Strain and Mortality Risk Among Critically Ill Patients With COVID-19—There Is No “Me” in COVID

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The coronavirus disease 2019 (COVID-19) pandemic has affected numerous communities, and reports of overburdened hospitals, specifically critical care units, have become commonplace. High-quality supportive care remains the foundation for ensuring that people with COVID-19 who are critically ill have the best chance of surviving. Such care in prepandemic times relied on sufficient expert staffing, specialized equipment, and appropriate environments of care to reliably implement a myriad of processes that are associated with better outcomes. Given that these resources may not all be consistently available when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly spreading throughout a community, Bravata et al1 sought to evaluate the association of critical care strain from March through November 2020 with COVID-19 mortality in 88 Veterans Administration hospitals with 10 or more intensive care unit (ICU) beds in the US.

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Article Information

Published: January 19, 2021. doi:10.1001/jamanetworkopen.2020.35041

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Rubinson L. JAMA Network Open.

Corresponding Author: Lewis Rubinson, MD, PhD, Morristown Medical Center, Atlantic Health System, 100 Madison Ave, Box 20, Morristown, NJ 07960 (lewis.rubinson@atlantichealth.org).

Conflict of Interest Disclosures: Dr Rubinson reported serving on the advisory board for and owning nominal equity in Ventec Life Systems outside the submitted work.

References
1.
Bravata  DM , Perkins  AJ , Myers  LJ ,  et al.  Association of intensive care unit patient load and demand with mortality rates in US Department of Veterans Affairs hospitals during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(1):e2034266. doi:10.1001/jamanetworkopen.2020.34266Google Scholar
2.
Kenyon  C .  Flattening-the-curve associated with reduced COVID-19 case fatality rates — an ecological analysis of 65 countries.   J Infect. 2020;81(1):e98-e99. doi:10.1016/j.jinf.2020.04.007 PubMedGoogle ScholarCrossref
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Horby  P , Lim  WS , Emberson  JR ,  et al; RECOVERY Collaborative Group.  Dexamethasone in hospitalized patients with Covid-19 — preliminary report.   N Engl J Med. 2020;NEJMoa2021436. Published online July 17, 2020. doi:10.1056/NEJMoa2021436PubMedGoogle Scholar
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US Food and Drug Administration.  Veklury (Remdesivir) EUA Letter of Approval. Reissued October 22, 2020. Accessed December 11, 2020. https://www.fda.gov/media/137564/download
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Fiolet  T , Guihur  A , Rebeaud  ME , Mulot  M , Peiffer-Smadja  N , Mahamat-Saleh  Y .  Effect of hydroxychloroquine with or without azithromycin on the mortality of COVID-19 patients: authors’ response.   Clin Microbiol Infect. 2020;27(1):138-140. doi:10.1016/j.cmi.2020.10.002 PubMedGoogle ScholarCrossref
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National Institutes of Health.  Antithrombotic therapy in patients with COVID-19. Updated December 17, 2020. Accessed December 13, 2020. https://www.covid19treatmentguidelines.nih.gov/adjunctive-therapy/antithrombotic-therapy/
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