| Summary: | During the first wave of the COVID-19 pandemic, some French regions were more affected than others. To relieve those areas most affected, the French government organized transfers of critical patients, notably by plane or helicopter. Our objective was to investigate the impact of such transfers on the pulse oximetric saturation (SpO<sub>2</sub>)-to-inspired fraction of oxygen (FiO<sub>2</sub>) ratio among transferred critical patients with COVID-19. We conducted a retrospective study on medical and paramedical records. The primary endpoint was the change in SpO<sub>2</sub>/FiO<sub>2</sub> during transfers. Thirty-eight patients were transferred between 28 March and 5 April 2020, with a mean age of 62.4 years and a mean body mass index of 29.8 kg/m<sup>2</sup>. The population was 69.7% male, and the leading medical history was hypertension (42.1%), diabetes (34.2%), and dyslipidemia (18.4%). Of 28 patients with full data, we found a decrease of 28.9 points in SpO<sub>2</sub>/FiO<sub>2</sub> (95% confidence interval, 5.8 to 52.1, <i>p</i> = 0.01) between the starting and the arrival intensive care units (SpO<sub>2</sub>/FiO<sub>2</sub>, 187.3 ± 61.3 and 158.4 ± 62.8 mmHg, respectively). Air medical transfers organized to relieve intensive care unit teams under surging conditions during the first COVID wave were associated with significant decreases in arterial oxygenation.
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