(COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in December 2019. As of Nov. 13, 2020, millions of infections have occurred, and COVID-19 has claimed more than 1.3 million lives, with an overall mortality rate of about 3% and mortality of up to 60% in the critically ill. 1-6 Limited information is available to describe the outcomes of patients admitted to intensive care units (ICUs) in Canada. The Jewish General Hospital was the first designated pandemic centre for adults in Montréal, Canada, the epicentre of COVID-19 in Canada during the first wave of the pandemic. 7 The first positive case of SARS-CoV-2 infection in the province of Quebec was diagnosed on Feb. 27, 2020. The Jewish General Hospital admitted Quebec's first patient with COVID-19 to the ICU on Mar. 5. As of May 27, 2020, the hospital had admitted 17% of all ICU patients with COVID-19 in the city. 8 Severe COVID-19 pneumonia is associated with progressive dyspnea, increasing hypoxemia and acute respiratory distress syndrome (ARDS), often occurring after 7-10 days of symptom onset, and requires ICU admission

Background: Intravenous (IV) hydration is considered a protective factor in reducing the incidence of acyclovir-induced nephrotoxicity. A systemsbased review of cases of acyclovir-associated acute kidney injury can be used to examine institution-, care provider-, and task-related factors involved in administering the drug and can serve as a basis for developing a quality improvement intervention to achieve safer administration of acyclovir.

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