• Enrico Buonamico, Vitaliano Nicola Quaranta, Esterina Boniello, Michela Dimitri, Valentina Di Lecce, Luciana Labate, Paola Pierucci, Elena Capozza, Giovanna Elisiana Carpagnano, and Onofrio Resta.
• Institute of Respiratory Disease, Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70125, Bari, Italy.
• Respir Investig. 2021 Sep 1; 59 (5): 602-607.

BackgroundPatients hospitalized for COVID-19-related pneumonia often need several degrees of ventilatory support, which are performed between Respiratory Intermediate Care Units (RICUs) and Intensive Care Units (ICUs), and which depend on the severity of acute respiratory distress syndrome. There is no firm consensus on transfer predictors from the RICU to the ICU.MethodsIn this retrospective observational single center study, we evaluated 96 COVID-19 patients referred to the RICU for acute respiratory failure (ARF) according to their transferal to the ICU or their stay at the RICU. We compared demographic data, baseline laboratory profile, and final clinical outcomes to identify early risk factors for transfer.ResultsThe best predictors for transfer to the ICU were elevated C-reactive protein and lymphopenia. The mortality rate was lower in the RICU than in the ICU, where transferred patients who died were mostly younger men and with less comorbidities than those in the RICU.ConclusionsFew inflammatory markers can predict the need for transfer from the RICU to the ICU. Due to the ongoing COVID-19 pandemic, we urge better clinical stratification by early and meaningful profiles in patients admitted to the RICU who are at risk of transferal to the ICU.Copyright © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

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