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Letter to the Editor: Cytokine Blockade in Coronavirus Disease 2019: Keeping an Open Mind

From Critical Care Explorations.  This Letter to the Editor was written in response to the article by Rizvi and Gallo De Moraes entitled “New Decade, Old Debate: Blocking the Cytokine Pathways in Infection-Induced Cytokine Cascade.”


A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

From Critical Care Explorations.  In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12% -- significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20% to 25% in the United States for non–coronavirus disease 2019 patients. In this multi-center study, the authors report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar with before the coronavirus disease 2019 pandemic.


A High Neutrophil-Lymphocyte Ratio Is Associated With Increased Morbidity and Mortality in Patients With Coronavirus Disease 2019

From Critical Care Explorations.  This study aimed to evaluate the prognostic potential of admission neutrophil-lymphocyte ratio in patients admitted to the medical ICU with coronavirus disease 2019. The authors concluded that the neutrophil-lymphocyte ratio at the time of hospital admission is an independent risk factor for morbidity and mortality. This prognostic indicator may assist clinicians appropriately identify patients at heightened risk for a severe disease course and tailor treatment accordingly.


Letter to the Editor: Less Lumping and More Splitting: Why We Should Not Call COVID Sepsis

From Critical Care Medicine. This Letter to the Editor is in response to an editorial by Shappell et al. entitled “Does Severe Acute Respiratory Syndrome Coronavirus 2 Cause Sepsis?”


Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine. In this study, the authors found that ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, they concluded, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.


Editorial: Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?

From Critical Care Medicine. In this Editorial, the authors discuss the 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” and suggest that reemploying the use of evidence-based strategies developed over the past 20 years through rigorous controlled trials is one of the best mechanisms by which to help critically ill adults with COVID-19 liberate from the ICU and transition toward recovery and survivorship.


Coronavirus Disease 2019: A Pandemic Spawning an Infodemic

From Pediatric Critical Care Medicine. In this Special Article, the authors make a call for the field of pediatric critical care to “move forward.” They note that, over a short period, some of the best science and resources have been applied to children with COVID-19 or MIS-C, and that now clinicians and scientists have a different objective: to translate what they learn and know into the highest level of care for patients.


Editorial: Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?

From Critical Care Medicine. In this Editorial, the authors discuss the 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” and suggest that reemploying the use of evidence-based strategies developed over the past 20 years through rigorous controlled trials is one of the best mechanisms by which to help critically ill adults with COVID-19 liberate from the ICU and transition toward recovery and survivorship. 


Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine. In this study, the authors found that ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, they concluded, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.


Editorial: Utility of Coronavirus Disease 2019 Immune Profiling for the Clinician at the Bedside

From Critical Care Medicine. This Editorial was written in response to the article by de Roquetaillade et al. entitled “Comparison of Circulating Immune Cells Profiles and Kinetic Between Coronavirus Disease 2019 and Bacterial Sepsis,” which explores the relationship between the immune profile of COVID-19 patients and clinical outcomes.


Editorial: Coronavirus Disease 2019: There Is a Heart Between the Lungs

From Critical Care Medicine. This Editorial was written in response to the article by Chotalia et al. “Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome.”


Online Letter to the Editor: Optimal Management of Thrombotic Complications in Patients With Coronavirus Disease 2019

From Critical Care Medicine. This Online Letter to the Editor was written in response to an article by Mirsadraee et al. entitled “Prevalence of Thrombotic Complications in ICUTreated Patients With Coronavirus Disease 2019 Detected With Systematic CT Scanning.”


Development and Validation of ARC, a Model for Anticipating Acute Respiratory Failure in Coronavirus Disease 2019 Patients

From Critical Care Explorations. In this predictive modeling report, the authors sought to evaluate factors predictive of clinical progression among coronavirus disease 2019 patients following admission, and whether continuous, automated assessments of patient status may contribute to optimal monitoring and management.


Awake Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019 Patients Without Invasive Mechanical Ventilation

From Critical Care Explorations. This is a case report on the use of awake extracorporeal membrane oxygenation as a “treatment” for barotrauma due to severe acute respiratory distress syndrome in a coronavirus disease 2019 patient, without the need for invasive mechanical ventilation.


Return to Work After Coronavirus Disease 2019 Acute Respiratory Distress Syndrome and Intensive Care Admission: Prospective, Case Series at 6 Months From Hospital Discharge

From Critical Care Medicine. In this Online Brief Report, the authors describe rates of return to work versus unemployment following coronavirus disease 2019 acute respiratory distress syndrome requiring intensive care admission.


Using Nonheparin Anticoagulant to Treat a Near-Fatal Case With Multiple Venous Thrombotic Lesions During ChAdOx1 nCoV-19 Vaccination-Related Vaccine-Induced Immune Thrombotic Thrombocytopenia

From Critical Care Medicine. The authors describe the successful recovery from multiple and life-threatening venous thrombosis after ChAdOx1 nCoV-19 vaccination.


Scarce Resource Allocation in a Pandemic: A Protocol to Promote Equity, Timeliness, and Transparency

From Critical Care Explorations. Drawing on expertise in critical care medicine, bioethics, and political science, the authors propose a decision-making protocol to ensure fairness in the resolution of conflict, timely decision-making, and accountability to improve system response.


Examination of Early CNS Symptoms and Severe Coronavirus Disease 2019: A Multicenter Observational Case Series

From Critical Care Explorations. In this observational study, the authors found that early CNS symptoms, and pecifically encephalopathy, are differentially associated with risk of severe coronavirus disease 2019 and may serve as an early marker for differences in clinical disease course.


Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center

From Critical Care Medicine. In Massachusetts, triage guidelines were designed based on acute illness and chronic life-limiting conditions. In this study, the authors sought to retrospectively validate this protocol to cohorts of critically ill patients from their hospital.


Impact of Nonpharmaceutical Interventions on ICU Admissions During Lockdown for Coronavirus Disease 2019 in New Zealand—A Retrospective Cohort Study

From Critical Care Medicine.  In this study, the authors found that the he institution of nonpharmaceutical interventions was associated with a significant decrease in elective and acute ICU admissions and ICU resource use. These findings may help hospitals and health authorities planning for surge capacities and elective surgery management in future pandemics.