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Editorial: The Long Road to Normalcy Following Survival From COVID-19–Associated Acute Respiratory Distress Syndrome

From Critical Care Medicine. This editorial accompanies an article by Carenzo et al. entitled “Return to Work After Coronavirus Disease 2019 Acute Respiratory Distress Syndrome and Intensive Care Admission: Propsective, Case-Series at 6 Months From Hospital Discharge” and calls for future studies to identify evidence for best practice during treatment of acute phase of infection to mitigate some of the long lasting effects as well as factors to help maximize rehabilitation efforts to help survivors to return to their everyday lives.


Editorial: Glucocorticoid-Glucocorticoid Receptor Response to Severe Acute Respiratory Syndrome Coronavirus 2

From Critical Care Medicine. This Editorial accompanies an article by Vassiliou et al. entitled “Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients.”


Online Letter to Editor: Optimal Patient Selection for the Prophylactic Anticoagulation Therapy in Patients With Coronavirus Disease 2019

From Critical Care Medicine. This Online Letter to the Editor was written in response to an article by Santoro et al. entitled “Anticoagulation Therapy in Patients With Coronavirus Disease 2019: Results From a Multicenter International Prospective Registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019 [HOPE-COVID19]).”


Online Letter to the Editor: The Janus Face of Coronavirus Disease 2019–Associated Coagulopathy

From Critical Care Medicine. This Online Letter to the Editor is in response to an article by Doyle et al. entitled “A comparison of thrombosis and hemorrhage rates in patients with severe respiratory failure due to coronavirus disease 2019 and influenza requiring extracorporeal membrane oxygenation.”


Online Letter to the Editor: Reasons for the Overuse of Sedatives and Deep Sedation for Mechanically Ventilated Coronavirus Disease 2019 Patients

From Critical Care Medicine. This Online Letter to the Editor was written in response to an article by Wongtangman et al. entitled “Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019-Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study.”


Endothelial Dysfunction as a Component of Severe Acute Respiratory Syndrome Coronavirus 2–Related Multisystem Inflammatory Syndrome in Children With Shock

From Critical Care Medicine. In this article, the authors found that endothelial dysfunction is associated with severe acute respiratory syndrome coronavirus 2–related multisystem inflammatory syndrome in children with shock and may constitute one of the underlying mechanisms.


Epidemiological and Clinical Characterization of Superinfections in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Explorations. Prevalence of superinfections in coronavirus disease 2019 patients requiring mechanical ventilation was high in this series, and bacterial superinfections were independently associated with ICU or 28-day mortality (whichever comes first).


Operationalizing Ethical Guidance for Ventilator Allocation in Minnesota: Saving the Most Lives or Exacerbating Health Disparities?

From Critical Care Explorations. In this article, the authors note that the Ventilator Allocation Score can accurately identify patients with high rates of short-term mortality. However, these high mortality patients only represent 27% of all the patients who died, limiting the utility of the score for allocation of scarce resources. The score may unfairly prioritize older patients and inadvertently exacerbate racial health disparities through the inclusion of specific comorbidities such as end stage renal disease. Triage frameworks that include age should be considered. Purposeful efforts, the authors say, must be taken to ensure that triage protocols do not perpetuate or exacerbate prevailing inequities.


Cardiopulmonary Exercise Testing in Critically Ill Coronavirus Disease 2019 Survivors: Evidence of a Sustained Exercise Intolerance and Hypermetabolism

From Critical Care Explorations.  In this study, the authors found prolonged reduced exercise capacity up to 6 months in critically ill coronavirus disease 2019 survivors. This disability did not result from residual pulmonary or cardiac dysfunction but rather from a metabolic disorder characterized by a sustained hypermetabolism and an impaired oxygen utilization.


Pharmacotherapy in Coronavirus Disease 2019 and Risk of Secondary Infections: A Single-Center Case Series and Narrative Review

From Critical Care Explorations. The authors sought to evaluate the impact of pharmacologic approach to coronavirus disease 2019 within the ICU on secondary infections and clinical outcomes.


Empirical Assessment of U.S. Coronavirus Disease 2019 Crisis Standards of Care Guidelines

From Critical Care Explorations. The authors found that this proof-of-principle study demonstrates the feasibility and importance of empirical testing of crisis standards of care guidelines to understand whether they meet their goals.


Awake Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Acute Respiratory Failure

From Critical Care Explorations. This report demonstrates that in a selected group of patients, an “awake” venovenous extracorporeal membrane oxygenation approach is feasible and may result in favorable outcomes.


Trends in 28-Day Mortality of Critical Care Patients With Coronavirus Disease 2019 in United Kingdom: A National Cohort Study, March 2020 to January 2021

From Critical Care Medicine. The authors sought to determine whether the previously described trend of improving mortality in people with coronavirus disease 2019 in critical care during the first wave was maintained, plateaued, or reversed during the second wave in United Kingdom, when B117 became the dominant strain.


Trends in ICU Mortality From Coronavirus Disease 2019: A Tale of Three Surges

From Critical Care Medicine. The authors sought to determine the association between time period of hospitalization and hospital mortality among critically ill adults with coronavirus disease 2019.


Ischemic and Hemorrhagic Stroke Among Critically Ill Patients With Coronavirus Disease 2019: An International Multicenter Coronavirus Disease 2019 Critical Care Consortium Study

From Critical Care Medicine. In an international registry of ICU patients with coronavirus disease 2019, stroke was infrequent. Hemorrhagic stroke, but not ischemic stroke, was associated with increased mortality. Further, both hemorrhagic stroke and ischemic stroke were associated with traditional vascular risk factors. Extracorporeal membrane oxygenation use was strongly associated with both stroke and death.


Body Mass Index and Mortality in Coronavirus Disease 2019 and Other Diseases: A Cohort Study in 35,506 ICU Patients

From Critical Care Medicine. The authors concluded that, the obesity paradox, which is the inverse J-shaped association between BMI and mortality in critically ill patients, is not present in critically ill patients with COVID-19–related respiratory failure in contrast to non-SARS-CoV-2 viral and bacterial respiratory infections. Nevertheless, once admitted to the ICU, obese COVID-19 patients also do not have a higher risk for mortality than patients with normal weight.


Mortality Among Noncoronavirus Disease 2019 Critically Ill Patients Attributable to the Pandemic in France

From Critical Care Medicine. In this study, the authors found that in hospital units with moderate or high levels of coronavirus disease 2019 critically ill patients, noncoronavirus disease deaths were at higher levels.


Natriuretic Peptide Levels and Clinical Outcomes Among Patients Hospitalized With Coronavirus Disease 2019 Infection

From Critical Care Explorations. In this study, the authors hypothesized that pro-B-type natriuretic peptide level would be associated with mortality and clinical outcomes in hospitalized coronavirus disease 2019 patients.


Online Letter to the Editor: The Limitations of Standardized Mortality Ratios for Coronavirus Disease 2019 ICU Patients

From Critical Care Medicine. In this Online Letter to the Editor, the authors discuss the article by Higgins et al. entitled “Coronavirus Disease 2019 ICU Patients Have Higher-Than-Expected Acute Physiology and Chronic Health Evaluation-Adjusted Mortality and Length of Stay Than Viral Pneumonia ICU Patients.”


Editorial: Severe COVID-19 and Stroke—Another Piece in the Puzzle

From Critical Care Medicine. In this Editorial, the authors discuss an article by Cho et al. entitled “Ischemic and hemorrhagic stroke among critically ill patients with coronavirus disease 2019: An international multicenter coronavirus disease 2019 critical care consortium study.”