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Submission content Introduction: Intensive care medicine has become an admired, loved, hated, and definitely more interesting Specialty due to a special situation (COVID-19) that exposed the training process to numerous criticisms, positives, and negatives, and this is how I believe we could improve our beloved world. Proposal: 1. Ideal training program from medical school to Certificate of Completion of Training (CCT): * Medical school: In their last year they should do more than 1 week in the Intensive Care Unit (ICU) * Stage 1: there should be a core surgical training of at least 6 months * Stage 2: there should be a rotation on Psychiatry of at least 4 weeks with on calls in ICU and 2 weeks in Palliative Care * Stage 3: acting as a consultant for the last six months on ST7 with backup from a formal consultant, and * Surgical training should be included in the possible dual or triple CCT 2. How would we be assessed? I agree with the Faculty of Intensive Care Medicine (FICM) staging program assessment, with some modifications: * As ST7 the trainee should act as a consultant with back support at least 50% of the stage and need to be evaluated by a Multi-Source Feedback (MSF). * Clinical Fellows should have a consultant as a Certificate of Eligibility for Specialist Registration (CESR) guide who establishes the equivalent stage of training supporting them and assessing them under the same model. * Changing the way, the General Medical Council (GMC) conducts the CESR application and making it really equivalent to the ICM training with the FFICM curriculum. 3. What do we need to be taught? * Hot topics for ICU (academic), * Overseas talks to share experiences, * Ultrasound (FUSIC), * Wellbeing strategies, * Leadership training * Psychiatric and physiological effects post ICU for patients and staff, * The administrative and political model of the National Health Service (NHS), and * Communication skills to establish excellent relationships with the other specialties. 4. What would our working life look like? * Normal day: 8 am to 3 pm * Midday shift: 1 pm to 8:30 pm * Night shift: 8 pm to 8:30 am * A rolling rota of 12 weeks with 2 weekends during this time 5. How would you produce Intensive Care Medicine (ICM) Consultants of the future who both love their job and their life: * Starting with less intense shifts, * More cordial relationships between the teams, * Supporting ICM trainees and Fellows going through their CESR pathway, * Making the training more attractive to either male-female doctors getting them involved in as many different specialties as ICM can cover, Conclusion(s): Having full-time ICM Consultants should be welcome in all ICUs in the country, which is not at the moment. This will definitely attract a lot of excellent doctors who are 100% focused on ICM.
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Introduction: Medical students receive relatively little exposure to intensive care medicine throughout their undergraduate training in comparison to other specialties. The COVID-19 pandemic further hindered students' exposure with entrance to intensive care units (ICU) limited to conserve personal protective equipment (PPE) and reduce the risk of virus spread. To address this problem, this study explored the use of assisted reality technology to create a smart classroom whereby medical students can experience intensive care medicine with the COVID-19 risks mitigated. There is existing literature describing the use of live streaming ward rounds using wearable technology to teach medical students, however, we believe this is the first time assisted reality technology has been harnessed to develop a teaching curriculum on intensive care.1 Objectives: This study aimed to assess the feasibility of using a wearable headset with assisted reality technology to live stream intensive care teaching to remotely based medical students. Method(s): Three intensive care teaching sessions were live streamed to three groups of medical students using the AMA XpertEye wearable glasses. The teaching session focused on the intensive care bed space and equipment as well as the assessment of a critically unwell intensive care patient. Two educators were required to facilitate the optimum learning environment. One educator wore the assisted reality technology glasses on the ICU whilst the other educator remained with the students to facilitate group discussion. The educators had the means to communicate via inbuilt technology on the glasses. Feedback from students was collected using the evaluation of technology-enhanced learning materials (ETELM).2 Results: The response rate for the ETELM survey was 100%. Students strongly agreed that the session was well organised, relevant and that the navigation of technology-based components was logical and efficient. 'There was a strong instructor presence and personal touch to the session' returned the strongest positive response. 'This session will change my practice' received the most varied response from students, potentially due to their stage in undergraduate training and distance from actual clinical practice. Students strongly disagreed that their learning was affected by technology issues. Educators reported problems with securing a patient appropriate to be involved alongside the busy clinical demands of the ICU. Facilitation by trained educators was crucial to ensure the teaching sessions were high quality. Conclusion(s): The use of smart classrooms on intensive care using assisted reality technology was very well received by medical students and educators. The main limitations included the necessity to balance the delivery of teaching alongside the clinical demands of the unit, however this is arguably the case with most forms of clinical teaching. There is the potential to continue using smart classrooms in the post-pandemic period, as they provide an open and safe platform for students to explore intensive care medicine and to ask questions that they may feel less able to raise in the busy clinical environment.
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The SARS-coronavirus 2 disease initially reported in December 2019 in China (COVID-19) represents a major challenge for intensive care medicine, due to the high number of ICU admission and the prolonged stay for many patients. Up to 5% of COVID-19 infected patients develop severe acute hypoxemic respiratory failure requiring invasive mechanical ventilation as supportive treatment. Apart from early antiviral and anti-inflammatory treatment, the management of COVID-19 patients is mainly applying protective mechanical ventilation, to support the injured lungs. However recently acquired data and clinical experience suggest that COVID-19-related ARDS presents some specificities that will be summarized in the present article.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.
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Introduction: Effective handover between treating clinical teams is an important part of communication in the care of patients leaving the intensive care environment.1 This can be even more vital in neurocritical care, where patients may be unable to communicate their own history due to neurological deficits and whose families are unable to visit due to COVID. These patients often have had complex neurosurgical interventions and ongoing complex MDT discussion due to the nature of their illness. Handover needs to represent this. Furthermore, as a specialist tertiary centre, many patients leave the unit as repatriations to other intensive care units. In these situations, it is even more important for good handover to contain the relevant and succinct information for ongoing care. Objective(s): We aim to improve the quality of handover from the intensive care team to ward teams at a specialist neurocritical care centre through the use of an electronic discharge proforma integrated into the electronic patient record (EpicCare Epic Systems Corporation). This is a system that has only recently been introduced locally and has required modification for the intensive care environment. Method(s): We performed a retrospective cohort study of documented transfer of care (TOC) summaries for patients entering the ICU in a month-long period. 67 patient admissions were identified as possible candidates with 11 cases excluded as not meeting criteria. The TOC summaries of suitable cases were compared to standards set by the Faculty of Intensive Care Medicine and Intensive Care Society and criteria tailored to the neuro-intensive care environment. Following this, we implemented a curated discharge proforma for all patients leaving intensive care. Through the use of smart lists and specific prompts, we aim to improve compliance with the guidelines and improve the quality of TOC. The project is currently ongoing and we aim to repeat the analysis in March 2022 to review if there has been improved compliance. Result(s): Compliance for the first round of discharges was variable. There was generally good quality information on the summary of stay of the patient (96%) and ongoing plan for the care of the patient (88%). However, documentation of the rehabilitation needs (32%), psychological needs (14%), communication needs (16%), safeguarding issues (4%), and resuscitation and escalation status of the patient was suboptimal (4%). Documentation of verbal handover to the parent team (25%) and critical care outreach team (45%) was mixed. Conclusion(s): Here we present the use of an electronic discharge proforma to improve the quality of handover in patients leaving the intensive care environment. While the study is ongoing, we show that currently local patient handover is often incomplete with a lack of detail in the TOC summary and poor verbal communication between teams. Through the use of this proforma, we aim to improve the quality of this handover and improve the continuity of care for patients leaving the neuro-intensive care unit.
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Objectives: The COVID-19 pandemic has had a major impact on the healthcare system, which has been forced to manage large num-bers of patients, including those with respiratory insufficiency and in need of oxygen therapy. Due to concerns about bacterial co-in-fection, antibiotic therapy was administered to many patients. The aim of the present study was to compare antimicrobial resistance in intensive care patients in the pre-pandemic and pandemic periods. Material(s) and Method(s): Patients hospitalized at the Department of Anesthesiology, Resuscitation and Intensive Care Medicine of the University Hospital Olomouc in the pre-COVID-19 period (2018-2019) and during the pandemic (2020-2021) were enrolled in the stu-dy. Clinical samples from the lower respiratory tract were routinely collected twice a week, with one strain of a given species first isolated from each patient being included in the study. Result(s): While several bacterial species (Escherichia coli, Proteus mirabilis and Haemophilus influenzae) were found to occur less fre-quently, an increased occurrence was documented for Enterococcus faecium, Serratia marcescens and Klebsiella variicola. Overall, ho-wever, it can be concluded that there was no major change in the frequency of bacterial pathogens isolated from the lower respiratory tract during the COVID-19 period. Similarly, with only a few exceptions, antimicrobial resistance did not change significantly. More significant increases in resistance to piperacillin/tazobactam, cefotaxime, ciprofloxacin and gentamicin have been demonstrated for Serratia marcescens. However, a decrease in the resistance of Pseudomonas aeruginosa and Burkholderia cepacia complex to mero-penem was also observed. Conclusion(s): There was no significant change in the frequency of bacterial pathogens and their resistance to antibiotics during the COVID-19 pandemic. However, there was an increase or decrease in the percentage of some species and in their resistance.Copyright © 2022, Trios spol. s.r.o.. All rights reserved.
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The intensive care medicine literature continued to resonate with the fading COVID-19 pandemic in 2022. Nevertheless, several interesting scientific publications have appeared in the field of critical care nephrology, the contents of which are worth mentioning. This summary article aims to guide the reader through the most fundamental aspects of nephrotoxicity, acute kidney injury, and extracorporeal purification methods.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
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It is paradoxical that being the immune response the key of the evolution from infection to sepsis, rapid tests for monitoring the immune response at bedside have not been developed and successfully implemented. The epidemic of COVID has provided a good sepsis paradigm originated from a viral trigger. It emphasizes the importance on individualization on different clinical phenotypes and the importance of time in therapeutic management. Whereas measures effective in reducing the viral burden can be effective if started very early, they are useless if delayed. Moreover, the effectiveness of some monoclonal antibodies used very early opens an opportunity to expand therapy in other viral or bacterial infections, particularly in immunocompromised subjects. Lastly, the success in reducing mortality by the use of steroids in patients requiring additional oxygen is a new paradigm to be expanded through the use of different immunomodulatory agents in a precision therapy approach. With the experience learned from COVID-19 disease, next steps for sepsis management improvement with potential impact on outcomes should focus on: (a) identification of subclinical phenotypes at the bedside, using clinical and biological markers;(b) implementation of a precision medicine strategy, balancing the use of therapy targeted to reduce the organism burden at the onset and of immunomodulatory agents in a second time window;(c) development of immune response assessment at the bedside, early after the diagnosis of serious infections, to anticipate individual infected patients at high risk of developing sepsis and to customize specific preemptive therapies based on the risk. © 2023 Elsevier Inc. All rights reserved.
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In 2022, intensive medicine all around the world gradually began to return to standard tracks, although we could still observe the effects of the pandemic waves of the disease COVID-19. In the literature, we could note the publication of research studies of "violently terminated" pandemics and new works. This review article presents a selection of the most interesting published articles in general intensive care medicine and those focusing on cardiovascular issues.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
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During the COVID-19 pandemic, large numbers of elderly, multimorbid people required treatment in intensive care units. This study investigated how the inherent patient factors age and comorbidity burden affected the treatment strategy and the outcome achieved. Retrospective analysis of data from intensive care patients enrolled in the Lean European Open Survey on SARS-CoV2-Infected Patients (LEOSS) cohort found that a patient's age and comorbidity burden in fact influenced their mortality rate and the use of ventilation therapy. Evidence showed that advanced age and multimorbidity were associated with the restrictive use of invasive ventilation therapies, particularly ECMO. Geriatric patients with a high comorbidity burden were clustered in the sub-cohort of non-ventilated ICU patients characterized by a high mortality rate. The risk of death generally increased with older age and accumulating comorbidity burden. Here, the more aggressive an applied procedure, the younger the age in which a majority of patients died. Clearly, geriatric, multimorbid COVID-19 patients benefit less from invasive ventilation therapies. This implies the need for a holistic approach to therapy decisions, taking into account the patient's wishes.
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The coronavirus disease 2019 (COVID-19) pandemic can lead to a severe course of disease in immunosuppressed patients requiring intensive care unit treatment even though a number of new vaccines and new antiviral drugs exist. One of the main reasons for this is the generally poorer immune response under immunosuppression. Therefore, it is all the more important to know the stages of the disease and to select the currently available therapeutic options accordingly.Copyright © 2023, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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Introduction: Sepsis refers to systemic inflammatory reactions caused by infections, which was the common complication after severe infections, trauma, burns, shock, and major surgery. Septic shock and multiple organ dysfunction syndromes associated with sepsis and its progression were common in intensive care units (ICU). Acute kidney injury (AKI) was a common complication of sepsis. The clinical mortality rate for sepsis was about 20%-50%, and may be as high as 70% if sepsis was associated with acute kidney injury (S-AKI). Therefore, there was a need to initiate the diagnosis and risk stratification of AKI in patients with sepsis, which will contribute to effective intervention and good prognosis. Currently, although the treatment of S-AKI was becoming better understood, diagnostic criteria for AKI were still based on elevated serum creatinine levels or decreased urine volume with the low sensitivity and specificity. Therefore, the use of current diagnostic criteria was not sufficient. The ratio of neutrophils to lymphocytes and platelets (N/LP) was a low-cost measure that could be obtained through routine blood tests and is often used to reflect the inflammatory state of the body. Its usefulness as a predictor of COVID-19 prognosis and the incidence of AKI after abdominal and cardiovascular surgery has been demonstrated. The aim of this study was to determine whether elevated N/LP is associated with the risk and severity of S-AKI within 7 days after admission to the ICU of adult sepsis patients in the Department of Intensive Care Medicine, the First Affiliated Hospital of Soochow University. Method(s): Statistical analysis was performed using SPSS22.0. Data with a normal distribution were expressed as mean +/- standard deviation, and data without a normal distribution was expressed as median and interquartile distance (IQR). When variables has normal distributions and homogenous variances, the independent sample T-test and one-way ANOVA were used to compare the means, and then the minimum significant difference (LSD) test was performed. The rank sum test was used to compare variables with non-normal distribution. P value below 0.05(*) was considered statistically significant. Result(s): A total of 45 patients with sepsis from 2021/01/1-2021/12/31 were enrolled in the first ward of Intensive Care Department of the First Affiliated Hospital of Soochow University, among which 20 patients with sepsis developed AKI within 7 days after admission to ICU. The N/LP values of sepsis patients and S-AKI patients did not conform to the normal distribution, but satisfied the normal distribution after logarithmic conversion. Independent sample T test showed that there was a significant difference between the two groups. Further comparison was made between patients with sepsis and patients with S-AKI at each stage. The data were in line with normal distribution after logarithmic conversion, and statistical difference was found after one-way ANOVA. There were significant increases in S-AKI3 stage compared with sepsis patients, S-AKI3 stage compared with S-AKI2 stage and S-AKI3 stage compared with S-AKI1 stage. Conclusion(s): Elevated N/LP levels may be associated with the development of S-AKI and severe AKI in patients with sepsis within 7 days after admission to ICU. No conflict of interestCopyright © 2023
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BACKGROUND: Severity scores and mortality prediction models (MPMs) are important tools for benchmarking and stratification in the intensive care unit (ICU) and need to be regularly updated using data from a local and contextual cohort. Simplified acute physiology score II (SAPS II) is widely used in European ICUs. METHODS: A first-level customization was performed on the SAPS II model using data from the Norwegian Intensive Care and Pandemic Registry (NIPaR). Two previous SAPS II models (Model A: the original SAPS II model and Model B: a SAPS II model based on NIPaR data from 2008 to 2010) were compared to the new Model C. Model C was based on patients from 2018 to 2020 (corona virus disease 2019 patients omitted; n = 43,891), and its performances (calibration, discrimination, and uniformity of fit) compared to the previous models (Model A and Model B). RESULTS: Model C was better calibrated than Model A with a Brier score 0.132 (95% confidence interval 0.130-0.135) versus 0.143 (95% confidence interval 0.141-0.146). The Brier score for Model B was 0.133 (95% confidence interval 0.130-0.135). In the Cox's calibration regression α ≈ 0 and ß ≈ 1 for both Model C and Model B but not for Model A. Uniformity of fit was similar for Model B and for Model C, both better than for Model A, across age groups, sex, length of stay, type of admission, hospital category, and days on respirator. The area under the receiver operating characteristic curve was 0.79 (95% confidence interval 0.79-0.80), showing acceptable discrimination. CONCLUSIONS: The observed mortality and corresponding SAPS II scores have significantly changed during the last decades and an updated MPM is superior to the original SAPS II. However, proper external validation is required to confirm our findings. Prediction models need to be regularly customized using local datasets in order to optimize their performances.
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COVID-19 , Simplified Acute Physiology Score , Humans , Pandemics , Hospital Mortality , Critical Care , Intensive Care Units , Norway/epidemiology , Registries , ROC CurveABSTRACT
Goal:To determine incidence of bacterial superinfections, causative pathogens demographic data, relevant laboratory parameters and outcomes in critically ill COVID-19 patients treated in primary respiratory intensivist center (PRIC) UH Dubrava. Patients and methods: In this retrospective observational study, clinical and laboratory data of 692 critically ill patients treated in PRIC UH Dubrava between March 1st 2020. and February 1st 2021. was collected using the hospital information system software (BIS) and statistical analysis was performed using the jamovi statistical package. Results: Out of 692 patients admitted to the ICU, 383 acquired bacterial or fungal superinfections. 305 acquired pneumonia, 133 bloodstream infections and 120 urinary infections. 66.3% of patients were males, and bacterial superinfections were more common in patients admitted from hospital wards or external ICUs. Out of 305 patients with pneumonia, 295 were receiving mechanical ventilation and satisfied the criteria for ventilator associated pneumonia. Patients with bloodstream infections maintained elevated neutrophil lymphocyte ratio, lymphopenia and elevated CRP levels on day 7 compared to those without BSI. Urinary infections were more common in females, and did not have an effect on outcomes. All patients that developed superinfections had prolonged ICU and hospital stay. Conclusion: Incidence of bacterial superinfections in critically ill COVID-19 patients is 55.3%. Most common infections are ventilator associated pneumonia, bloodstream infections and urinary infections. Most common pathogens are multi-drug resistant pathogens. Patients with bacterial superinfections have longer ICU and hospital stay, and in these patients, persistent elevation of NLR ratio and worsening of lymphopenia are characteristic for patients with worse outcomes © 2022 Hrvatski Lijecnicki Zbor. All rights reserved.
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Superinfections with Aspergillus spp. in patients with Coronavirus disease 2019 (CAPA: COVID-19-associated pulmonary aspergillosis) are increasing. Dexamethasone has shown beneficial effects in critically ill COVID-19 patients. Whether dexamethasone increases the risk of CAPA has not been studied exclusively. Moreover, this retrospective study aimed to identify risk factors for a worse outcome in critically ill COVID-19 patients. Data from 231 critically ill COVID-19 patients with or without dexamethasone treatment from March 2020 and March 2021 were retrospectively analysed. Only 4/169 (6.5%) in the DEXA-group and 13/62 (7.7%) in the Non-DEXA group were diagnosed with probable CAPA (p = 0.749). Accordingly, dexamethasone was not identified as a risk factor for CAPA. Moreover, CAPA was not identified as an independent risk factor for death in multivariable analysis (p = 0.361). In contrast, elevated disease severity (as assessed by Sequential Organ Failure Assessment [SOFA]-score) and the need for organ support (kidney replacement therapy and extracorporeal membrane oxygenation [ECMO]) were significantly associated with a worse outcome. Therefore, COVID-19 treatment with dexamethasone did not increase the risk for CAPA. Moreover, adequately treated CAPA did not represent an independent risk factor for mortality. Accordingly, CAPA might reflect patients' severe disease state instead of directly influencing outcome.
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Introduction: Evidence suggest that critically ill COVID-19 patients are at higher risk of developing anxiety symptoms, which may be related to or exacerbated by patients concerns regarding their health status and recovery. Objective(s): To assess anxiety symptoms in critically ill COVID-19 survivors, 1-2 months after hospital discharge and to analyze its association with concerns reported by patients regarding their own health status and recovery. Method(s): In the framework of MAPA prospective research, this preliminary study included COVID-19 patients admitted in the Intensive Care Medicine Department (ICMD) of a University Hospital. Patients were excluded if they had an ICMD length of stay (LoS) <=24h, terminal illness, major auditory impairment or inability to communicate at the evaluation time. Participants were assessed at a scheduled telephone follow-up appointment, with Generalized Anxiety Disorder Scale (GAD-7). Additional questions were asked to assess the survivors' post-discharge concerns regarding discrimination against for COVID-19, infection of a family member, re-infection or sequelae related to COVID-19. Result(s): Eighty-three patients were included (median age=63 years;63% male) and 24% had anxiety symptoms. Anxiety scores were higher in survivors who reported being afraid of being discriminated against for COVID-19 (30% vs 10%;p=0.034), being re-infected (100% vs 79%;p=0.032) and having sequelae (94% vs 44%;p<0.001). Conclusion(s): These findings revealed that anxiety is common in COVID-19 survivors and is associated with post-discharge patients concerns that may limit patient daily living. This study emphasizes the importance of psychological assessment and follow-up of the COVID-19 survivors, in order to support these patients recovery.
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Introduction: Long-term neuropsychiatric consequences of critical illness are well known. Therefore, it is expected that critical COVID-19 patients might also present several psychiatric symptoms such as depression, with inevitable negative effect on healthrelated quality of life (HRQoL), commonly used as an indicator of illness and treatment impact. Objective(s): To identify depressive symptoms in critical COVID-19 survivors and to examine its association with HRQoL domains. Method(s): This preliminary study involved critical COVID-19 patients admitted into the Intensive Care Medicine Department (ICMD) of a University Hospital, between October and December of 2020. Patients with an ICMD length of stay (LoS)<=24h, terminal illness, major auditory loss, or inability to communicate at the follow-up time were excluded. From 1-2 months after discharge, all participants were evaluated by telephone at follow-up appointment, with Patient Health Questionnaire (PHQ-9) (depression) and EuroQol 5-dimension 5-level EQ-5D-5L (HRQoL). This study is part of the longitudinal MAPA project. Result(s): Eighty-three patients were included with a median age of 63 years (range: 31-86) and the majority were male (63%). The most reported problems on EQ-5D-5L domains were usual activities (82%) and mobility (76%). About 27% presented depressive symptoms, and with more problems of self-care (68%vs41%;p=0.029), pain/discomfort (86%vs49%;p=0.002), and anxiety/depression (96%vs54%;p<0.001). Conclusion(s): These preliminary results are in line in previous studies in critical COVID-19 survivors, with depression being associated with worse HRQoL. Bearing this in mind, follow-up approaches with an early screening and treatment of these psychiatric symptoms will be fundamental to optimize the recovery of these patients.
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BACKGROUND & AIMS: Dysphagia can be a consequence of prolonged hospitalization in intensive care units (ICUs) due to severe SARS-CoV-2 pneumonia. This study aims at Identifying the risk factors for dysphagia in ICU patients with COVID-19 pneumonia requiring invasive mechanical ventilation, and at determining the frequency of postextubation dysphagia in this population. METHODS: Observational, descriptive, retrospective, cohort study of SARS-CoV-2 pneumonia patients admitted into the ICUs from March to May 2020. The Modified Viscosity Volume Swallowing Test (mV-VST) was used to screening for dysphagia during the first 48 h of extubation in patients requiring mechanical ventilation. Descriptive statistics, univariate and multivariate analyses were conducted. A logistic regression was applied to construct a predictive model of dysphagia. RESULTS: A total of 232 patients were admitted into the ICUs (age [median 60.5 years (95% CI: 58.5 to 61.9)]; male [74.1% (95% CI: 68.1 to 79.4)]; APACHE II score [median 17.7 (95% CI: 13.3 to 23.2)]; length of mechanical ventilation [median 14 days (95% CI: 11 to 16)]; prone position [79% (95% CI: 72.1 to 84.6)]; respiratory infection [34.5% (95% CI: 28.6 to 40.9)], renal failure [38.5% (95% CI: 30 to 50)])). 72% (167) of patients required intubation; 65.9% (110) survived; and in 84.5% (93) the mV-VST was performed. Postextubation dysphagia was diagnosed in 26.9% (25) of patients. APACHE II, prone position, length of ICU and hospital stay, length of mechanical ventilation, tracheostomy, respiratory infection and kidney failure developed during admission were significantly associated (p < 0.05) with dysphagia. Dysphagia was independently explained by the APACHE II score (OR: 1.1; 95% CI: 1.01 to 1.3; p = 0.04) and tracheostomy (OR: 10.2; 95% CI: 3.2 to 32.1) p < 0.001). The predictive model forecasted dysphagia with a good ROC curve (AUC: 0.8; 95% CI: 0.7 to 0.9). CONCLUSIONS: Dysphagia affects almost one-third of patients with SARS-COV-2 pneumonia requiring intubation in the ICU. The risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy, and poorer prognosis on admission (worst APACHE II score).