A total of 21 cases were included (mean age, 70 years [range, 43-92 years]; 52% male). 17 patients (81%) were admitted to the ICU less than a day after admission to Evergreen Hospital in Washington. Mechanical ventilation was initiated in 15 patients (71%). Acute respiratory distress syndrome (ARDS) was observed in 100% of the patients requiring mechanical ventilation and 8 of 15 (53%) developed severe ARDS by 72 hours. In this population, mortality was 67%, with 24% of patients remaining critically ill after publication, and only 9.5% discharged from the ICU.