 Critical COVID patients are at increased risk for developing ventilator associated pneumonia, VAP. This can lead to serious complications, including death. Factors contributing to higher rates of VAP in these patients include understaffing, lack of personal protective equipment, and use of immunosuppressant medications. Additionally, severe lung damage, immune system dysfunction, pulmonary vascular endothelial inflammation and thrombosis, and frequent growth of gram-negative bacteria, have all been observed in these patients. As a result, it is important to recognize the signs and symptoms of VAP early on so that appropriate treatments can be initiated quickly. This article was authored by Sean Boyd, Satin Se, Alejandro Rodriguez, and others.