COVID-19-related organ dysfunction and management strategies on the intensive care unit: a narrative review

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pathophysiology

Background:

• The COVID-19 pandemic caused a surge in critically ill patients, straining intensive care resources.
• Understanding COVID-19's complex multisystem inflammatory vasculopathy and its high mortality implications is crucial.
• Variations in institutional outcomes suggest management strategies significantly influence patient survival.

Purpose of the Study:

• To review the pathophysiology of COVID-19 in critically ill patients.
• To outline effective management strategies for intensive care clinicians.
• To share collective learning from a high-volume severe respiratory failure center.

Main Methods:

• Review of existing literature on COVID-19 pathophysiology and critical care.
• Analysis of experiential learning and management strategies implemented in a London-based intensive care unit.
• Synthesis of information on organ support and adjunctive therapies.

Main Results:

• COVID-19 presents as a complex multisystem inflammatory vasculopathy with significant mortality risk.
• Optimal organ support and adjunctive therapies are still being defined, relying on current literature and experience.
• Strategic institutional preparation and meticulous intensive care are vital for improving outcomes.

Conclusions:

• Effective management of critically ill COVID-19 patients requires a deep understanding of pathophysiology and adaptive strategies.
• Sharing clinical experiences and learning is essential for optimizing care during the pandemic.
• Intensive care management plays a pivotal role in mitigating COVID-19 mortality.