Zhou et al. reported in the Lancet that in 50% of fatal cases a secondary infection which occurred at of median of 17 days. Moreover, 100% of fatal developed sepsis/viremia at a median of 10 days.
Raises the possibility of a strong compensatory anti-inflammatory response/immunoparalysis effect compounded with lymphopenia. Timing of corticosteroids and immunomodulatory therapies are a point of concern.
Curious what type of secondary infections you are seeing (if any) in your ICU?
Lippi and Plebani recommended serial procalcitonin measurement in hospitalized patients with COVID-19, as they found a nearly 5-fold higher risk of severe SARS-CoV-2 infection with an elevated PCT. (https://www.sciencedirect.com/science/article/pii/S0009898120301066?via%3Dihub)