Arentz M, Yim E, Klaff L, et al. - Researchers reported on the clinical presentation, characteristics, and outcomes of incident cases of coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) at Evergreen Hospital in Washington state to inform other healthcare providers treating critically ill patients with COVID-19. A total of 21 patients with PCR-confirmed COVID-19 (mean age: 70 years) admitted to the ICU at Evergreen Hospital between February 20, 2020, and March 5, 2020, were included in this case series. Chest radiographs were assessed by an intensivist and a radiologist, and patient outcome data were evaluated after ≥ 5 days of ICU care or at the time of death. No analysis for statistical significance was performed. Comorbidities were identified in 86% of cases, with chronic kidney disease and congestive heart failure being the most common. Initial symptoms included shortness of breath, fever, and cough. The mean onset of symptoms prior to presenting to the hospital was 3.5 days, and 17 patients were admitted to the ICU < 24 hours following hospital admission. Abnormal chest radiograph was observed in 20 patients at admission, with the most common findings on initial radiograph being bilateral reticular nodular opacities and ground-glass opacities. By 72 hours, however, 18 patients had bilateral reticular nodular opacities and 14 had evidence of ground-glass opacities. Fourteen patients had an absolute lymphocyte count of < 1,000 cells/μL, and liver function tests were abnormal in 8 patients at admission. Importantly, mechanical ventilation was initiated in 15 patients, with acute respiratory distress syndrome (ARDS) observed in 15 of 15 patients requiring mechanical ventilation; 8 of 15 developed severe ARDS by 72 hours. Cardiomyopathy developed in seven patients. As of March 17, 2020, mortality was 67%, 24% of patients have remained critically ill, and 9.5% have been discharged from the ICU. The researchers noted that it is unclear whether the high rate of cardiomyopathy reflects a direct cardiac complication of COVID-19 or resulted from overwhelming critical illness.