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The Viral Infection and Respiratory Illness Universal Study (VIRUS) is a prospective, cross-sectional, observational study and registry of all eligible adult and pediatric patients who are admitted to a hospital. Marilyn N. Bulloch, PharmD, BCPS, FCCM, was joined by Rahul Kashyap, MD, MBA, at the 2023 Critical Care Congress to discuss the Discovery VIRUS COVID-19 Registry.
SCCM assists the critical care community during disasters and emergencies by providing resources and updates.
Khorog, the regional capital of Gorno-Badakhshan Autonomous Oblast (GBAO), sits at an elevation of 2200 meters among the beautiful but rugged and isolated Pamir Mountains, where some people live at elevations of 4000 meters or more. In this resource-limited region, the Soviet-era healthcare system differs markedly from that of the United States.
Although only a small number of patients hospitalized with COVID-19 present with a secondary bacterial pneumonia, a large percentage are unnecessarily treated with antibiotics. Hear about how physicians and hospitalists can identify when antibiotics are unnecessary for hospitalized patients with moderate to severe respiratory infections. This podcast is sponsored by bioMérieux.
The COVID-19 pandemic exposed major gaps in the U.S. healthcare system, prompting the National Emerging Special Pathogens Training and Education Center (NETEC) to form the National Special Pathogen System of Care (NSPS) to prepare the country for the next large-scale outbreak. Discovery, the Critical Care Research Network, and its Severe Acute Respiratory Infection – Preparedness (SARI-PREP) program are helping lead the way in this new vision. SARI-PREP is a key player in the effort to establish a coordinated and standardized healthcare network that provides high-quality care to parents with a special pathogen, while also protecting healthcare workers.
Clazakizumab is a monoclonal antibody against human interleukin-6 that may benefit patients hospitalized with severe or critical COVID-19 accompanied by hyperinflammation. Although not yet FDA approved, clinical trials are underway worldwide. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, is joined by Bonnie E. Lonze, MD, PhD, to discuss the article, “A Randomized Double-Blinded Placebo Controlled Trial of Clazakizumab for the Treatment of COVID-19 Pneumonia With Hyperinflammation.”
The Research Plan provides the first U.S. government-wide national research agenda focused on advancing prevention, diagnosis, treatment, and provision of services and supports for individuals and families experiencing Long COVID. The reports represent the federal government’s response to ensure the acceleration of scientific progress and to provide individuals with Long COVID with the support and services they need. They affirm the U.S. government’s commitment to addressing the impacts of Long COVID with federal government resources, in collaboration with the private sector, and improving our Nation’s health and well-being.
The Services Report outlines federal services and mechanisms of support available to the public in addressing the longer-term effects of COVID-19. The reports represent the federal government’s response to ensure the acceleration of scientific progress and to provide individuals with Long COVID with the support and services they need. They affirm the U.S. government’s commitment to addressing the impacts of Long COVID with federal government resources, in collaboration with the private sector, and improving our Nation’s health and well-being.
The COVID-19 pandemic created a new challenging environment in which healthcare workers must survive. Before the pandemic, healthcare workers experienced burnout due to resource allocation and shortages, mental anguish, and long work hours. The pandemic further exacerbated this situation, creating a new crisis within our already frayed healthcare system. This Concise Critical Appraisal dives into an article published in Critical Care Medicine that reviewed the causes of burnout and the correlation between the COVID-19 pandemic and workplace burnout.
On April 25, 2022, the distribution process for COVID-19 therapeutics to state and territorial health departments transitioned from the previous allocation process to one that more closely aligns with the allocation and ordering process for vaccines.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Neurology
Ritonavir, a strong cytochrome P450 (CYP) 3A4 inhibitor and a P-glycoprotein inhibitor, is coadministered with nirmatrelvir to increase the blood concentration of nirmatrelvir, thereby making it effective against SARS-CoV-2. Ritonavir may also increase blood concentrations of certain concomitant medications. Because ritonavir-boosted nirmatrelvir (Paxlovid) is the only highly effective oral antiviral for the treatment of COVID-19, drug interactions that can be safely managed should not preclude the use of this medication.
The Centers for Disease Control and Prevention (CDC) Nowcast data from April 5, 2022, estimates that the proportion of COVID-19 cases caused by the Omicron BA.2 variant is above 50% in all Health and Human Services (HHS) U.S. regions. Data included in the health care provider fact sheet show the authorized dose of sotrovimab is unlikely to be effective against the BA.2 sub-variant. Due to these data, sotrovimab is not authorized in any U.S. state or territory at this time.
On April 14, 2022, the FDA revised the Emergency Use Authorization (EUA) for the COVID-19 oral antiviral therapeutic Paxlovid to authorize an additional dose pack presentation with appropriate dosing for patients with moderate renal impairment within the scope of the EUA. As a result, Paxlovid will soon be available in two package presentations.
In a study supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Advancing Translational Sciences, and the National Institute on Drug Abuse, researchers enrolled 209 people ages 18 to 89 who had laboratory-confirmed SARS-CoV-2 infections.
Little is known about the epidemiology of ventilator-acquired pneumonia among COVID-19 patients. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Charles-Hervé Vacheron, MD, to discuss a cohort exposed/nonexposed study that found a higher incidence of ventilator-associated pneumonia among COVID-19 patients compared with the general population.
Post-ICU COVID-19 clinics are newly established programs providing care for patients with post-intensive care syndrome (PICS) related to COVID-19. During this webcast, subject matter experts discussed how post-ICU COVID-19 clinics developed with an interdisciplinary model improve outcomes and support patients, family members, and transitions of care.
The ICU Heroes Award recognizes that patients and families are an integral part of intensive care unit (ICU) care. The award is given to an ICU patient and family and to the multiprofessional team that delivered the care.
From Critical Care Explorations The authors describe the structure and process characteristics of existing and newly implemented ICU-RCs and COVID-RCs in a subset of large health systems in the United States.
From Critical Care Explorations The authors determine the factors associated with mortality in venovenous extracorporeal membrane oxygenation (V-V ECMO) patients with COVID-19 infection and provide an updated report of clinical outcomes for patients treated with V-V ECMO for COVID-19 in Minnesota.
From Critical Care Explorations In this Letter to the Editor the authors concluded that the pattern of albumin kinetics may be predictive of outcome in COVID-19 and sepsis-induced ARDS.
From Critical Care Explorations The authors compare the demographics and outcomes of hospitalized patients during New York City’s third wave of COVID-19 to the first two waves.
From Critical Care Medicine In this Letter to the Editor the authors write in reponse to Ibarra-Estrada et al.
From Critical Care Medicine In this Letter to the Editor the authors respond to Dandel et al.
From Critical Care Medicine In this Letter to the Editor the authors write in response to Chotalia et al.
From Critical Care Medicine In this Letter to the Editor the authors respond to Jha et al.
From Critical Care Medicine In this Letter to the Editor the authors write in reponse to Chotalia et al.
From Critical Care Medicine In this Editorial the authors write an accompanying piece to Mesotten et al.
From Critical Care Medicine The authors quantify the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival.
From Critical Care Medicine The authors investigated healthcare system–driven variation in general characteristics, interventions, and outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.
WHO has updated its living guidelines on COVID-19 therapeutics to include a conditional recommendation on molnupiravir, a new antiviral medicine. This is the first oral antiviral drug to be included in the treatment guidelines for COVID-19. As this is a new medicine, there is little safety data. WHO recommends active monitoring for drug safety, along with other strategies to mitigate potential harms.
Through this program, people are able to get tested and – if they are positive and treatments are appropriate for them – receive a prescription from a health care provider, and have their prescription filled all at one location. These “One-Stop Test to Treat” sites are available at hundreds of locations nationwide, including pharmacy-based clinics, Health Resources Services Administration (HRSA)-supported federally-qualified health centers (FQHCs), and long-term care facilities. People can continue to be tested and treated by their own health care providers who can appropriately prescribe these oral antivirals at locations where the medicines are distributed.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Professional Development
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Pulmonary
Brendan G. Carr, MD, MA, MS, will address some of the realities of the COVID-19 pandemic and how health systems can prepare during the Peter Safar Memorial Lecture at the 2022 SCCM Congress.
Explore the Surviving Sepsis Campaign's guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19) (Alhazzani W, et al. Crit Care Med. 2020;46:854-887) with host Kyle B. Enfield, MD, and authors Mitchell M. Levy, MD, MCCM, and Waleed Alhazzani, MD, MSc, FRCPC.
Review neurologic manifestations of COVID-19 and other severe respiratory viral contagions (Robinson C, et al. Crit Care Explor. 2020;2:e0107) with host Ludwig H. Lin, MD, and author Christopher P. Robinson, DO, MS.
Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020;21:662-666) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.
Explore the need for randomized COVID-19 clinical trials and the difficulties and potential consequences of misinformation (Ingraham N, et al. Crit Care Explor. 2020;2:e0108) with host Ashish K. Khanna, MD, FCCP, FCCM, and Nicholas E. Ingraham, MD.
Discovery, the Critical Care Research Network's Viral Infection and Respiratory Illness Universal Study creates a real-time COVID-19 registry of current ICU and hospital care patterns.
The National Institutes of Health has released Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.
Clinicians are working to understand and formulate an effective treatment for COVID-19-associated acute respiratory distress syndrome (Marini J. Crit Care Med. 2020 May 13; Epub ahead of print).
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital.
The increase in acute kidney injury in COVID-19 patients is resulting in more utilization of renal replacement therapy (RRT) and continuous renal replacement therapy. Host Pamela M. Peeke, MD, MPH, FACP, FACSM , is joined by Michael J. Connor Jr, MD, to review RRT utilization.
Procalcitonin testing on admission seems to be a valuable piece of information for early risk assessment and ruling out bacterial co-infection in COVID-19 patients. Host Pamela M. Peeke, MD, MPH, is joined by Michael Broyles, PharmD, and Eric H. Gluck, MD, to explore this topic.
COVID-19 is associated with a high prevalence of coagulopathy and venous thromboembolism. Explore what clinicians need to know about this serious problem and how it impacts care delivery.
Severe COVID-19 infection can be a form of viral sepsis with occasionally concomitant bacterial infection. Explore the definition of sepsis and overlap with case descriptions of patients with severe COVID-19, treatment, and more.
This infographic highlights key points from the SCCM Free webcast Caring for pregnant patients with COVID-19.
This infographic reviews strategies to develop a multiprofessional team approach to COVID-19 ventilator management with highlights from the SCCM Free webcast Interdisciplinary COVID-19 Ventilator Management.
This infographic highlights key points from the Free SCCM webcast revisiting precautions, engineering and hazard controls.
During this webcast, subject matter experts addressed questions on how to manage patients with COVID-19 in a rural location with limited resources, how to treat patients with limited equipment, and how to manage resources when there are bed shortages.
COVID-19 complicated critical care clinicians’ decision-making with regard to tracheostomy. ICU resource constraints and risk of staff exposure during an aerosol-generating procedure necessitated rapid adaption of clinical practice in the setting of many unknowns.
Extubation is a high-risk endeavor in some COVID-19 patients. Host Pamela M. Peeke, MD, MPH, FACP, FACSM, is joined by Joshua H. Atkins, MD, PhD; Christopher Rassekh, MD; and Ara Chalian, MD, to discuss this topic.
Discuss strategies for personal and professional well-being.
During the COVID-19 pandemic, healthcare providers have received many requests for media appearances and interviews to help inform the public. This infographic provides strategies and techniques to increase confidence of providers participating in media communications.
Review strategies to develop a multiprofessional team approach to COVID-19 ventilator management in this FREE SCCM webcast. A multiprofessional panel of experts will discuss how each clinician’s role contributes to optimal ventilator management.
Review the three part approach to management of Vaccination Status Conflicts.
Discuss coping skills and strategies to assist health care providers or colleagues experiencing burnout.
Review the risk factors for AKI in COVID-19 patients and mechanism for renal injury in COVID-19 patients.
Review the incidence of acute kidney injury (AKI) and renal replacement therapy (RRT) in COVID-19 versus other diseases, mortality and long-term prognosis.
From Critical Care Explorations The authors report three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A).
From Critical Care Explorations The authors describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19.
From Critical Care Explorations The authors studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.
From Critical Care Explorations The authors aim to increase clinician awareness of, and risk factors for ARC in patients with COVID-19, especially in comparison to other critical illnesses.
From Critical Care Explorations The authors investigate microvascular function in patients with critical coronavirus disease 2019.
From Critical Care Explorations The authors describe outcomes after cardiopulmonary resuscitation for in-hospital cardiac arrest in two COVID-19 patient cohorts.
From Critical Care Explorations In this Letter to the Editor the authors investigated the effect of prone ventilation on right ventricular (RV) function of intubated patients with COVID-19–associated acute respiratory distress syndrome.
From Critical Care Explorations The authors evaluated the characteristics and outcomes across the range of frailty in patients admitted to ICU with coronavirus disease 2019.
From Critical Care Explorations The authors conducted eleven team triage simulations from December 2020 through February 2021.
From Critical Care Explorations The authors test the hypothesis that relatively lower clot strength on thromboelastography maximum amplitude (MA) is associated with development of venous thromboembolism (VTE) in critically ill patients with COVID-19.
From Critical Care Explorations The authors report successful treatment in such a patient who is ineligible for phase 3 trials of Aviptadil.
From Critical Care Medicine In this Letter to the Editor, the authors read the study by Chotalia et al.
From Critical Care Medicine The authors determined the association between temperature trajectories and distinct manifestations of coronavirus disease 2019.
Top officials for the American Hospital Association and the Center to Advance Palliative Care (CAPC) convened virtually for a fireside chat to discuss the impact and importance of palliative care practices during the pandemic and share stories from experts in the field.
The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the emergency use of bebtelovimab for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg): with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by FDA are not accessible or clinically appropriate.
All specialties and disciplines can strengthen their care of patients living with a serious illness. For CAPC members, CAPC’s online training curriculum provides free continuing education credits for physicians, nurses, social workers, and case managers at member organizations. Free ABIM MOC (Maintenance of Certification) credits are also available for physicians.
Whether your organization is in the middle of a COVID-19 surge or planning forward, Center to Advance Palliative Care (CAPC) has tools, technical assistance, clinical training, and convening opportunities to help.
Drawn from best practices, CAPC toolkits are curated, proven resources for improving the care of people living with serious illness. Toolkits include technical assistance and tools for palliative care teams; serious illness strategies for health systems, health plans, and ACOs; resources for skill-building among clinicians from all specialties and disciplines; and much more.
In this "Breathe Easy Elevator Pitch" podcast, Dr. Siva Bhavani interviews Dr. David Furfaro, and they discuss the study "Latent Class Analysis Reveals COVID-19-related ARDS Subgroups", recently published in the Blue Journal.
Peta M.A. Alexander, MBBS, FRACP, FCICM, will present the Max Harry Weil Memorial Lecture titled, “What Has COVID-19 Taught Us About ECMO?” during SCCM’s 2022 Critical Care Congress.
During this webinar, experts will address questions related to caring for mechanically ventilated pregnant patients with COVID-19. Review the safety of extracorporeal membrane oxygenation in pregnancy, drug safety for critically ill patients with COVID-19, vaccination strategies, and post-ICU care for unvaccinated pregnant patients. This webcast will also benefit non-ICU clinicians who may need to care for critically ill and injured patients.
Revisit isolation precautions, engineering controls, and aerosol-generating procedures, and review personal protective equipment updates, including the evolution of masking recommendations.
Understanding the frequency with which new symptoms and conditions emerge in the months following SARS-CoV-2 infection is important to inform patients’ expectations for recovery and allow health care professionals and health systems to address patients’ needs. Shortness of breath, fatigue or muscle weakness, and mild subjective cognitive dysfunction (ie, “brain fog”) are among the most commonly reported persistent symptoms in the months following SARS-CoV-2 infection.
The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes.
Myocarditis is inflammation of the heart muscle. This can happen after viral infections like COVID-19 and, very rarely, after receiving mRNA COVID-19 vaccines. Most people with myocarditis following vaccination recover completely with rest and simple treatment. However, myocarditis from COVID-19 can be very severe.
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has undertaken comprehensive efforts to support our call for a national plan to address Post-Acute Sequelae of SARS-CoV-2 infection (PASC or Long COVID) and the millions Americans it is affecting. The PASC Dashboard serves to estimate those affected including state and county level data and trends over time.
This is a podcast series accounting for the parallel pandemics of COVID-19 and clinician burnout, while introducing the story of one undocumented patient who helped to reveal the authentic feelings and values of his healthcare team. With historically high mortality rates in the ICU and pervasive emotional and physical fatigue, this ICU team in Marietta, Georgia had the courage to hope and the commitment to care.
WHO has recommended two new drugs for COVID-19, providing yet more options for treating the disease. The extent to which these medicines will save lives depends on how widely available and affordable they will be. The first drug, baricitinib, is strongly recommended for patients with severe or critical COVID-19. WHO has also conditionally recommended the use of a monoclonal antibody drug, sotrovimab, for treating mild or moderate COVID-19 in patients who are at high risk of hospitalization.
HHS Presentation - Topics include: Introduction to COVID-19 Outpatient Therapeutics & Product Selection, Tools to Assist in COVID-19 Outpatient Therapeutic Selection, Overview of Emergency Use Authorizations, Oral Antiviral Indications and Dosing, Provider and Patient EUA Fact Sheets, Overview of Outpatient Therapeutic Distribution Process
The national map below displays public locations that have received shipments of U.S. Government-procured COVID-19 therapeutics under U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) authority. The locations displayed in the locator have reported stock on hand within the last day.
Medicare & COVID-19 Monoclonal Antibody Products: Coverage, Coding, Payment and Billing. Monoclonal antibody products to treat Coronavirus disease 2019 (COVID-19) help the body fight the virus or slow the virus’s growth. Medicare beneficiaries have coverage without beneficiary cost sharing for these products when used as authorized or approved by the Food and Drug Administration (FDA).
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Procedures
During the COVID-19 pandemic, healthcare providers receive many requests for media appearances and interviews to help inform the public. This training will provide strategies and techniques to increase confidence of providers participating in media communications.
The COVID-19 Treatment Guidelines Panel (the Panel) has recommended several therapeutic agents for the treatment and prevention of SARS-CoV-2 infection in individuals who are at high risk for progression to severe COVID-19. These anti-SARS-CoV-2 therapeutics are of greatest benefit for nonhospitalized patients who have risk factors for progression to severe COVID-19. With the increase in cases of COVID-19 and the emergence of the Omicron (B.1.1.529) variant of concern, there may be logistical or supply constraints that make it impossible to offer the available therapy to all eligible patients, making patient triage necessary.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Epidemiology-Outcomes
John J. Gallagher, DNP, RN, CCNS, CCRN-K, TCRN, RRT, FCCM, will bring his experiences and teaching enjoyment to SCCM’s 2022 Critical Care Congress, where he will lead the thought leader session “Critical Care Nurses and COVID-19.”
Critical Care Explorations The authors found a similar percentage of positive test results in mini-bronchoalveolar lavage and bronchoalveolar lavage samples in patients with suspected coronavirus disease 2019–associated pulmonary aspergillosis, indicating that mini-bronchoalveolar lavage could be a useful tool for coronavirus disease 2019–associated pulmonary aspergillosis screening in ICU patients.
Critical Care Explorations In this study, the authors concluded that soluble CD14 subtype levels may have prognostic utility in coronavirus disease 2019.
From Critical Care Medicine The authors review the pathogenesis, clinical presentation, diagnosis, and treatment of vaccine-induced immune thrombotic thrombocytopenia, an unexpected consequence of the coronavirus disease 2019 pandemic era.
From Critical Care Explorations This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard.
From Critical Care Explorations In this observational study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.
From Critical Care Explorations In this essay, the authors propose a number of questions that recognize the existential frustrations critical care professionals experience when carting for unvaccinated patients in the ICU, while also uncovering the ethical obligations that remain.
From Critical Care Explorations In this paper, the authors aimed to characterize the kinetics of serum albumin in critically ill patients with coronavirus disease 2019 compared with critically ill patients with sepsis-induced acute respiratory distress syndrome.
From Critical Care Explorations This hypothesis-generating study suggests that the pathophysiology of immunothrombosis differs between coronavirus disease 2019 patients and noncoronavirus disease septic patients.
From Critical Care Explorations In this descriptive statistical study, heart rate variability measures were found to be statistically different across critically ill patients infected with severe acute respiratory syndrome coronavirus 2 and distinct from bacterial sepsis.
From Critical Care Explorations In this study, the authors found that Patients who suffered critical illness from coronavirus disease 2019 had a high frequency of postintensive care syndrome after 1 year.
The WHO Therapeutics and COVID-19: living guideline contains the Organization’s most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges.
AHA published a new blog post from an LLN member hospital titled, The Pandemic. “How a Bold, New Strategy Took on Health Care Inequities During the Pandemic,” authored by Luminis Health Chief Diversity Officer Tamiko Stanley.
December 22, 2021, the FDA issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is available by prescription only and should be initiated as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.
The FDA has granted molnupiravir emergency use authorization (EUA) to treat mild to moderate COVID-19 in adults at high risk of severe illness. High risk people include adults aged 65 and over and people with certain medical conditions. The FDA also states that molnupiravir should only be used when other COVID-19 treatments are unavailable.
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Richard Wunderink They discuss Dr. Wunderink's recent publication in the Blue Journal about bacterial superinfection in patients intubated and mechanically ventilated for COVID-19 pneumonia. Dr. Wunderink is a Professor of Medicine in Pulmonary and Critical Care at Northwestern University in Chicago, Illinois.
The fourth and current wave of the COVID-19 pandemic has created a worrisome landscape for the nursing profession. Nurses across the country report that they no longer feel celebrated as heroes as they did in the early days of the pandemic. This AHA Podcast covers nurse leaders discussing COVID-19 nursing challenges, and solutions.
During the COVID-19 pandemic, people have been exposed to an abundance of information from a large number of sources.
On December 3, 2021, the U.S. Food and Drug Administration revised the emergency use authorization (EUA) of bamlanivimab and etesevimab (previously authorized for pediatric patients 12 years of age and older weighing at least 40 kilograms, or about 88 pounds), to additionally authorize bamlanivimab and etesivimab administered together for the treatment of mild to moderate COVID-19 in all younger pediatric patients, including newborns, who have a positive COVID-19 test and are at high risk for progression to severe COVID-19, including hospitalization or death. This revision also authorizes bamlanivimab and etesevimab, to be administered together, for post-exposure prophylaxis for prevention of COVID-19 in all pediatric patients, including newborns, at high risk of progression to severe COVID-19, including hospitalization or death.
Questions to Guide Evidence-Informed, Data Driven and Person-Centered Decision-Making. Summary of evidence and sources
In this review, the epidemiologic and pathophysiologic features, diagnosis, and treatment of COVID-19 pulmonary thrombosis and thromboembolism are discussed.
Infographic: Symptoms, Risk Factors, Screening, Recovery Programs
Research Question: Does the rate of VTE among adults hospitalized with COVID-19 differ from matched hospitalized control participants without COVID-19?
COVID in Focus: Perspectives on the Literature. Brief summary and highlights specific studies in the COVID-19 literature is a curated review of key information and literature about this topic. It is not comprehensive of all data related to this subject.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Neurology
From Pediatric Critical Care Medicine. In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.
From Critical Care Medicine In this Editorial, the authors discuss the article by Vacheron et al. on the epidemiology of ventilatory-associated pneumonia among patients with COVID-19.
From Critical Care Explorations While the overall safety profile of the BNT162b2 coronavirus disease 2019 vaccine remains excellent for the general population, rare serious events have been reported. In this case report, the authors describe a case of multisystem inflammation and organ dysfunction of unknown mechanism beginning shortly after administration of the first dose of BNT162b2 coronavirus disease 2019 vaccine in a previously healthy recipient.
From Critical Care Explorations. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard.
From Critical Care Explorations. In this study the authors found that hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials.
From Critical Care Explorations. In this study, the authors successfully identified significant genetic factors in OAS1 and IL1B genes using a candidate gene approach study as valuable information for further mechanistic investigation and predictive model building.
From Critical Care Explorations. Dorsal Push and Abdominal Binding Improve Respiratory Compliance and Driving Pressure in Proned Coronavirus Disease 2019 Acute Respiratory Distress Syndrome
This webinar covers highlights from the Critical Impact: Ethics and Supply Chain course.
Stay up to date on the mass vaccination efforts in the United States with this SCCM webcast. Thought leaders will address current COVID-19 variants and vaccine efficacy and review pediatric vaccination considerations. This webcast is the second in a series of updates that SCCM is producing to better educate clinicians as vaccination efforts continue. The webinar was held on December 8, 2021.
Learn how COVID-19 is becoming an endemic condition in intensive care units in this FREE SCCM webcast. Subject matter experts will also discuss COVID-19 myths and misconceptions and how COVID-19 has changed the continuum of care. The Society of Critical Care Medicine and the Infectious Diseases Society of America partnered to produce this webcast. The webinar was held on December 14, 2021.
To help understand what moral distress looks like and how to manage and prevent it, the Society of Critical Care Medicine recently hosted the webcast Managing Moral Distress During a Pandemic.
With the average rate of daily new cases of COVID-19 on the rise—and the delta and omicron variants causing concern—the Society of Critical Care Medicine (SCCM) asked members in states with high rates of infection to share their experience and advice. Here are some of their insights.
In SCCM's webcast “Best Practices for Managing Staff Shortages,” a multiprofessional panel of experts discussed how staffing challenges arise in overwhelmed healthcare systems and how they have managed staff shortages.
With the rise in cases among children across the country, more healthcare professionals who typically work with adult patients are being tasked with treating pediatric patients. SCCM’s latest blog post summarizes two webcasts SCCM hosted to help smooth this transition.
This webinar covers highlights from the Critical Impact: Infrastructure and Workforce course.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Quality and Patient Safety.
This webinar covers highlights from the Critical Impact: Clinical Practice course.
From Critical Care Explorations. The authors describe statewide implementation of a critical care coordination center designed to optimize ICU utilization.
From Critical Care Explorations. The authors created evidence-based consensus statements for restricted ICU visitation policies to support critically ill patients, families, and healthcare professionals during current and future pandemics.
From Critical Care Explorations. In this single-center retrospective cohort, no significant differences in hospital mortality or length of stay between interhospital transfers and emergency department admits were found.
From Critical Care Explorations. The authors claim this to be the first study to clearly demonstrate significant practice variation between ICUs related to mechanical ventilation parameters that are under direct control by intensivists. Their effect on clinical outcomes for both coronavirus disease 2019 and other critically ill mechanically ventilated patients could have widespread implications for the practice of intensive care medicine and should be investigated further by causal inference models and clinical trials.
From Critical Care Medicine. In this study, the authors found that COVID-19 patients admitted to ICUs within one region, the Euregio Meuse-Rhine, differed significantly in general characteristics, applied interventions, and outcomes despite presumed genetic and socioeconomic background, admission diagnosis, access to international literature, and data collection are similar.
From Critical Care Medicine. In this study, the authors explored candidate prognostic and predictive biomarkers identified in retrospective observational studies (interleukin-6, C-reactive protein, lactate dehydrogenase, ferritin, lymphocytes, monocytes, neutrophils, D-dimer, and platelets) in patients with coronavirus disease 2019 pneumonia after treatment with tocilizumab, an anti–interleukin-6 receptor antibody, using data from the COVACTA trial in patients hospitalized with severe coronavirus disease 2019 pneumonia.
From Critical Care Explorations. The authors evaluated how the 3 Wishes Program evolved to allow continued provision of compassionate end-of-life care for critically ill patients during the coronavirus disease 2019 pandemic.
From Critical Care Explorations. The authors found that critically ill and mechanically ventilated coronavirus disease 2019 acute respiratory distress syndrome patients transferred from Appalachian critical access hospitals/rural facilities have increased mortality compared with noncoronavirus disease 2019 acute respiratory distress syndrome controls, suggesting that lack or delay in access to tertiary care may impact coronavirus disease 2019 outcome in rural areas.
From Critical Care Explorations. In this study, the authors sought to compare the rate of intubation and mortality of intubated patients in our ICUs between the first and second waves of the pandemic.
From Critical Care Explorations. In this Original Clinical Report, the authors conclude that respiratory non-invasive venous waveform analysis respiratory index represents a novel physiologic respiratory measurement with a promising ability to triage early care and predict the need for oxygen support therapy in coronavirus disease 2019 patients.
Conventional oxygen therapy is often insufficient to meet the significant oxygen needs of a patient with COVID-19 pneumonia. Several options for providing enhanced oxygen delivery have been studied throughout the COVID-19 pandemic. This webcast held on November 10, 2021, reviewed how some of these strategies are of particular use in patients with COVID-19 who have profound hypoxic respiratory failure.
As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). Pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. This webinar was held on October 15, 2021.
Review the concept of moral distress and how it can lead to burnout during a pandemic. Thought leaders will teach conflict management strategies and ways to better support your teams to avoid burnout. The Managing Moral Distress During a Pandemic webinar was held on November 11, 2021.
In the preliminary analysis of the VIRUS COVID-19 Registry of Discovery, the Critical Care Research Network, investigators discovered significant variations in mortality that were not readily explained by patient comorbidities, demographics, or severity of illness. It became evident that much of the disparity in outcomes was tied to variations in processes of care from one intensive care unit (ICU) to another. This realization inspired the creation of the STOP-VIRUS Learning Collaborative, which seeks to help participants rapidly evaluate and effectively implement best practice recommendations from the ever-evolving body of knowledge related to the care of critically ill patients with COVID-19.
This community developed resource is a quick reference guide for utlization of various COVID-19 pharmacotherapies.
During the COVID-19 pandemic, healthcare systems have been overwhelmed with patients, leading to clinician burnout and staffing issues. In this free webcast, learn how leaders from various intensive care units are managing staff shortages Webcast Recorded on Thursday, October 7, 2021. This webcast is cosponsored by the American Association of Critical-Care Nurses.
COVID-19 case presentation from the team at Mayo Clinic - Florida that brings together many of the STOP-VIRUS Collaborative lessons learned over the course of the past 6 months.
Erin Strong, BSN, RN, CCRN from the University of Pennsylvania, Amanda Frary, MSN, RN; Sydney O'Brien, RRT and Amber Dewey, RRT from Valleywise Health focus on the bedside experience during the Pandemic. Karen Korzick, MD from Geisinger Medical Center, discusses how these experiences can lead to moral distress, and place providers at risk for burnout. Closing the discussion, Karen Korzick, MD, Elly Fitzpatrick, DNP, RN, from Thomas Jefferson University, and Greg Martin, MD, from Emory University and current SCCM President, talk about team, unit, and organizational solutions that have been attempted to prevent, combat burnout. Curriculum Topic: Shared Decision-Making and End-of-Life Care
The Patient Perspective (Ken Burkhom) What the Bedside Nurse Sees (Erin Strong) How the ICU Team Adapts (Jackie Guiliani, Preeti John) Addressing the Repercussions of “Social Distancing” Requests for inappropriate care, managing conflict (Alex Kon) Shared decision making, care at the end of life & Social justice considerations (Giora Netzer) Impact of contingency, crisis operations on communication challenges (Mary Faith Marshall) Curriculum Topic: Shared Decision-Making and End-of-Life Care
Julia F. Taylor, MD, MA, HEC-C from the University of Virginia presents on the topic of Health Disparities; Katherine Fischkoff, MD from Columbia University presents on Resource Allocation; and Erin S. DeMartino, MD from Mayo Clinic presents on Pandemic Planning. Curriculum Topic: Shared Decision-Making and End-of-Life Care
Dr. Marlies Ostermann from Guy’s & St. Thomas’ NHS Foundation Hospital in London, UK, who covered the evaluation and management of acute kidney injury in patients with COVID-19, including a review of the COVID ADQI Work Group AKI consensus report. Curriculum Topic: Fluids, Electrolytes, and Acute Kidney Injury
Dr. Daniel Temas from Prisma Health will present a case study presentation. Paul Nyquist, MD, from MPH, the Johns Hopkins University School of Medicine, will provide an update on Stroke literature related to COVID and speak to thrombosis and Ischemic stroke impact. Curriculum Topic: Cardiovascular Complications: Venous Thromboembolism, Myocarditis, and Shock
From Critical Care Explorations. In this Brief Report the authors examined whether interleukin-6 in critical coronavirus disease 2019 is higher in arterial than in central venous blood, as a sign of predominantly local pulmonal rather than systemic interleukin-6 production.
From Critical Care Medicine. This Editorial accompanies the article by Angel et. al titled "Percutaneous Dilational Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation".
From Critical Care Medicine. This Editorial accompanies the article by Iba et. al titled "Recognizing vaccine-induced immune thrombotic thrombocytopenia".
From Critical Care Medicine. In this Review Article the authors established a uniform data collection process required to perform an assessment of any agent type using review criteria that were identified and differentially weighted for each agent class,
From Critical Care Medicine. In this Review Article the authors performed a systematic literature review to identify rates of barotrauma, pneumothorax, and pneumomediastinum in coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation.
From Critical Care Medicine. In this Clinical Investigation the authors determined the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and identified factors associated with burnout syndrome.
From Critical Care Medicine. In this Clinical Investigation the authors estimated the overall incidence of ventilator-associated pneumonia, the cumulative incidence, and hazard rate of the first and the second ventilator-associated pneumonia.
From Critical Care Medicine. In this Clinical Investigation the authors quantified the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival.
From Critical Care Medicine. In this Clinical Investigation the authors investigated the impact of prone positioning during venovenous extracorporeal membrane oxygenation support for coronavirus disease 2019 acute respiratory failure on the patient outcome.
From Critical Care Medicine. In this Clinical Investigation the authors conducted a multicenter study using whole-body CT to examine the prevalence, severity, and nature of vascular complications in coronavirus disease 2019 in comparison with patients with other viral pneumonias.
From Critical Care Medicine. In this Clinical Observation the authors describe the characteristics, ICU admissions, and outcomes among children hospitalized with coronavirus disease 2019 using Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 registry.
From Critical Care Medicine. In this Clinical Observation, the authors aimed to assess time to discharge and time to death in severe coronavirus disease 2019 in patients treated with high-flow nasal cannula compared with matched controls.
Groundbreaking study of hospitalized COVID-19 and influenza patients charts new path in critical care research Severe Acute Respiratory Infection – Preparedness (SARI-PREP) is a groundbreaking new research platform from SCCM’s Discovery, the Critical Care Research Network, that is leading the way in revolutionizing how critical care research is conducted in the United States. It will inform clinical management of patients with severe acute respiratory infection (SARI) and help ensure that health systems are better prepared for future pandemics.
Blog Posts related to COVID-19 pandemic.
As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). During this FREE webcast, pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. Webcast Recorded on Wednesday, September 22, 2021
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 8, 2021
From Critical Care Medicine. This is an Online Letter to the Editor written in response to Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome by Chotalia et al.
From Critical Care Explorations. In this study the authors found that functional impairment was common a year following the use of extracorporeal membrane oxygenation in coronavirus disease 2019, although the majority achieved independence in daily living and about half returned to work. Long-term anxiety, depression, and post-traumatic stress disorder were common, but cognitive impairment was not.
From Critical Care Explorations. In this study, the authors conclude that argatroban, with or without aspirin, is an effective anticoagulation strategy for patients who require venovenous extracorporeal membrane oxygenation support secondary to coronavirus disease 2019.
From Critical Care Explorations. In this article, the authors report a large case series and intermediate-term follow-up of cancer patients with coronavirus disease 2019 who were admitted to the ICU. Hospital mortality was 45%; intermediate-term outcome after hospital discharge was favorable.
From Critical Care Explorations. In this Commentary, that authors discuss bronchoscopy in patients with coronavirus disease 2019 and conclude that bronchoscopy should be strongly considered when clinically indicated.
From Critical Care Explorations. The data in this study provide further evidence for plasma exchange as a novel therapeutic strategy in a subset of critically ill coronavirus disease 2019 patients by potentially reversing the complex coronavirus disease 2019 immunopathology.
This video from the American Organization for Nursing Leadership (AONL) discusses new data from this nursing survey indicates access to PPE and the ability to communicate and implement changing policies have improved, while staffing shortages and the emotional health and well-being of nurse leaders have worsened.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Pediatrics
From Critical Care Explorations. In this study, the authors found that psychologic distress was common in coronavirus disease 2019 ICU survivors and remained similar until 6 months after hospital discharge.
From Critical Care Explorations. In this Brief Report, the authors sought to test the hypothesis that patients with acute respiratory distress syndrome due to coronavirus disease 2019, in whom acute respiratory distress syndrome is easily recognized, would be more likely to receive low tidal volume ventilation than concurrently admitted acute respiratory distress syndrome patients without coronavirus disease 2019.
From Critical Care Explorations. In this study, the authors examined the safety and feasibility of a multimodal in-person or telehealth treatment program, administered in acute recovery phase for patients surviving critical coronavirus disease 2019. They found that multimodal treatment program combining care from an interdisciplinary team in an ICU Recovery Clinic with physical rehabilitation is safe and feasible in patients surviving the ICU for coronavirus disease 2019 acute respiratory failure.
From Critical Care Explorations. In this study, the authors aimed compare machine learning algorithms and develop a simple tool for predicting 28-day mortality in ICU patients with coronavirus disease 2019.