Microbial, COVID-19, Diabetes mellitus, Critical tissue hypoxia, Life-threatening gas, Multiple Organ Dysfunction, Metabolic syndrome, Cardiovascular diseases, Ventilatory, Sarcopenia, Mitochondrial dysfunction, Biological

The world currently deals with the SARS-CoV-2 pandemic and its clinical form of Coronavirus Disease, first described in 2019 (COVID-19). Millions of patients suffer from dyspnea and low oxygenation, and many require artificial mechanical ventilation for acute respiratory failure. The most prominent problem is Acute Respiratory Distress Syndrome (ARDS), a life-threatening gas exchange impairment resulting in hypoxemia, hypercapnia followed by critical tissue hypoxia. The best ventilatory setting in ARDS, reducing the risk of Ventilator-Induced Lung Injury (VILI) is still a matter of debate in COVID-19. Other issues are the difficulties of diagnosing and treating the microbial super-infection, septic shock, and Multiple Organ Dysfunction (MODS). Intensive care medicine enhanced during the last decades resulting in the short-term outcomes (28day survival) improvement. However, the long-term outcomes, i.e., survivors’ quality of life, stay the same. In part, it is due to the growing amount of elderly critically ill patients. Age together with obesity and other chronic diseases (metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, liver and kidney diseases, sarcopenia, autoimmune disorders, cancer, etc.), are the main risk factors for an inappropriate inflammatory response to viral infection, e g, caused by SARS-CoV-2 [1].