ObjectivesThe COVID-19 pandemic presents unique challenges to the transportation of critically ill patients. In France, between mid-March and mid-April 2020, 660 COVID-19 patients were safely transported from four regions towards six other regions and four neighboring countries using various modes of transport (plane, helicopter, train, boat). The study aimed to assess costs for these transfers and compare the different transport options.MethodsA cost analysis was conducted including the operating costs for a specific transport distance and time, as well as associated personnel costs. We measured costs for each type of transport system, and costs for specific distances or time in operation, in order to perform comparisons for short, moderate, and long transport distances.ResultsOur preliminary findings indicated that using fixed-wing transport for patients was cheaper and more time-effective. For a reference distance of 500 km, which corresponds to the average distance traveled for such transfers, the cost of fixed-wing transport was around 1 625 € per patient. On the opposite, helicopters appeared to be the worst option (7 327 € per patient) whereas the train accounted for 5 136 euros per patient. In average, personnel costs represented around 13% of total costs.ConclusionsTo our knowledge, few studies have investigated the costs of patient transfers during the sanitary crisis. This study includes the first comprehensive cohort of transferred patients during COVID-19 pandemic, in France, between mid-March and mid-April 2020. The mode of transport conditions the number of patients transferred and the associated operating costs. Because there is potentially inconsistent data collection for some modes of transport, our study carries several limitations. We were also unable to measure specific time intervals for the preparatory and system disinfection phases. Further research should be conducted to better inform decision makers.