have oxygen saturation (spo2) ≤93 % on room air at sea level or a ratio of arterial oxygen partial pressure (pao2 in millimeters of mercury) to fractional inspired oxygen (fio2) \<300, respiratory rate ≥30 per minute, heart rate ≥125 per minute. have evidence of multi-organ dysfunction/failure. systolic blood pressure \<90 mmhg, diastolic blood pressure \<60 mmhg, or requiring vasopressors. require or anticipated impending need for endotracheal intubation, mechanical ventilation, oxygen delivered by high-flow nasal cannula noninvasive positive pressure ventilation, extracorporeal membrane oxygenation (ecmo).

have oxygen saturation (spo2) ≤93 % on room air at sea level or a ratio of arterial oxygen partial pressure (pao2 in millimeters of mercury) to fractional inspired oxygen (fio2) \<300, respiratory rate ≥30 per minute, heart rate ≥125 per minute. have evidence of multi-organ dysfunction/failure. systolic blood pressure \<90 mmhg, diastolic blood pressure \<60 mmhg, or requiring vasopressors. require or anticipated impending need for endotracheal intubation, mechanical ventilation, oxygen delivered by high-flow nasal cannula noninvasive positive pressure ventilation, extracorporeal membrane oxygenation (ecmo).

have oxygen saturation (spo2) ≤93 % on room air at sea level or a ratio of arterial oxygen partial pressure (pao2 in millimeters of mercury) to fractional inspired oxygen (fio2) <300, respiratory rate ≥30 per minute, heart rate ≥125 per minute. have evidence of multi-organ dysfunction/failure. systolic blood pressure <90 mmhg, diastolic blood pressure <60 mmhg, or requiring vasopressors. require or anticipated impending need for endotracheal intubation, mechanical ventilation, oxygen delivered by high-flow nasal cannula noninvasive positive pressure ventilation, extracorporeal membrane oxygenation (ecmo).

have oxygen saturation (spo2) ≤93 % on room air at sea level or a ratio of arterial oxygen partial pressure (pao2 in millimeters of mercury) to fractional inspired oxygen (fio2) <300, respiratory rate ≥30 per minute, heart rate ≥125 per minute. have evidence of multi-organ dysfunction/failure. systolic blood pressure <90 mmhg, diastolic blood pressure <60 mmhg, or requiring vasopressors. require or anticipated impending need for endotracheal intubation, mechanical ventilation, oxygen delivered by high-flow nasal cannula noninvasive positive pressure ventilation, extracorporeal membrane oxygenation (ecmo).