The present multicentric study describes 1,260 critically ill patients with COVID-19-associated acute respiratory failure consecutively admitted to 24 Italian ICUs during the first pandemic wave.

This study specifically analyzes the trends of clinical, ventilatory and laboratory parameters throughout the entire ICU stay and their relationship with outcome.

The daily values of 15 parameters associated with acute organ dysfunction (lung, liver, kidney), acid–base derangement, coagulation impairment, or systemic inflammation were associated with higher patient survival.

10 of these parameters showed different slopes between survivors and non-survivors, and the associations with the patient outcome of such slopes were stronger than the daily value of the same parameters.

This finding supports the common clinical knowledge that the time course of relevant variables is more relevant than the single daily value.

The overall ICU mortality rate was 34%, but increased to 38% if considering only the patients undergoing mechanical ventilation at ICU admission.

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