evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 , now characterized as a pandemic by the World Health Organization. 1 Infection rates and deaths worldwide increased exponentially. About 35 000 confirmed cases and more than 1600 deaths were reported in Canada as of Apr. 21, 2020. 2 In British Columbia, as of May 20, 2020, there were 2467 confirmed cases and 149 deaths. 3 However, the number of new cases has been decreasing since the beginning of April 2020. More than 85% of the cases of COVID-19 in BC have been located in the Metro Vancouver area. 3 Initial studies from China 4 and Italy 5 showed mortality ranging from 26% to 62% in critically ill patients with COVID-19. Studies from Seattle 6 and New York 7 reported overall mortality ranging from 23% to 50%. In these case series, between 13% and 71% of patients remained in the intensive care units (ICUs) at the time of publication, so actual mortality may be greater than reported.Canadian data describing critically ill patients with COVID-19 are lacking, and better characterization is crucial to direct critical care resource allocation and to understand the disease in our local context. The aim of our multicentre case series was to describe the demographic characteristics, management patterns and outcomes among critically ill patients with COVID-19 in Metro Vancouver. MethodsWe conducted a case series of all patients with COVID-19 admitted to an ICU in the Metro Vancouver area from Feb. 21 to Apr. 14, 2020, with outcomes followed until May 5, 2020. This area serves about 3 million residents of BC (population 4.9 million). The hospitals included were Vancouver General Hospital (46 ICU beds, quaternary hospital), Surrey Memorial Hospital (46 ICU beds, tertiary hospital), Lions Gate Hospital (11 ICU beds, community hospital),