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Purpose: To investigate clinical and laboratory tissue perfusion in addition to near-infrared spectroscopy (NIRS) static and dynamic-derived parameters in critically ill COVID-19 patients. Methods: A cross-sectional single-center exploratory study was performed. Twenty adult patients with confirmed COVID-19 admitted to the intensive care unit (ICU) within 24 hours were prospectively included in this study. A control group without COVID-19 was composed by forty patients included in recently published study. Accessed NIRS-derived parameters included basal tissue oxygen saturation (StO2), descending slope (%/min), ascending slope (%/min), maximum value of StO2 (StO2max), recovery time (s) and the area under the curve of reactive hyperemia. Results: The median (IQR) age of included patients was 58 (46-69) years. Patients with COVID-19 presented higher SAPS III score [50 (46-53) vs. 45 (30-53), p=0.04] compared with control patients. Patients with SARS-CoV-2 infection showed higher StO2 min [60 (49-79) vs. 54 (48-58) %; p=0.04] and lower descending slope [5.7 (3.4-8.8) vs. 8.1 (6.4-9.7) %/min; p<0.01] compared with ICU patients without COVID-19. Basal StO2 [80 (74-90) vs. 82 (76-86) %; p=0.89], StO2 max [(91 (83-95) vs. 90 (84-94) %; p=0.86], ascending slope [2.0 (1.1-2.9) vs. 2.2 (1.5-3.3) %/min; p=0.43], recovery time [14.5 (12.0-22.0) vs. 21.5 (14.3-28.3) s; p=0.13] and hyperemia area [10.3 (5.8-13.0) vs. 8.6 (4.0-14.3); p=0.55] did not differ between, respectively, COVID-19 and control groups. Conclusion: Severe COVID-19 patients exhibited a lower rate of oxygen extraction by peripheral tissues than non-COVID-19 critically ill patients, which may represent an adaptive mechanism to hypoxemia. This hypothesis needs to be further investigated.

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Between January and June 2015, the project provided CME-accredited education about organ donation for physician office staff in 122 randomized participating clinics across Western Pennsylvania and West Virginia. This included online and in-person training (lunch and learns) to over 1,500 PCP office staff participants as well as PCP office kits that included tabletop posters, brochures and office forms which included a survey and designation form. Results: Over 21,000 patient-completed organ donation survey forms were collected. About half of all participants were already registered organ donors. 764 (8.1%) completed the designation form and became registered organ donors upon receiving information from this pilot project. Due to the program's success, both Organ Procurement Organizations in Pennsylvania (CORE and Gift of Life) have committed to funding the program as a statewide initiative, to be launched in January 2016. Conclusion: Unique initiatives like the PSL project can help create awareness amongst people regarding the critical value of organ donation.

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