Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

Critical Care Medicine - Tập 48 Số 6 - Trang e440-e469 - 2020
Waleed Alhazzani1,2, Morten Hylander Møller3,4, Yaseen M. Arabi5,6, Mark Loeb1,2, Michelle N. Gong7, Eddy Fan5,8, Simon Oczkowski1,2, Mitchell M. Levy9,10, Lennie Derde5,11, Amy Dzierba2,12, Bin Du3,2, Michael S. Aboodi7, Hannah Wunsch13,6,4, Maurizio Cecconi5,14,7,8, Younsuck Koh15,10, Daniel S. Chertow16,9, Kathryn Maitland1,17, Fayez Alshamsi18,2, Emilie P. Belley‐Côté1,2, Massimiliano Greco14,7,8, Matthew Laundy3,19, Jill S. Morgan1,4, Jozef Kesecioğlu11, Allison McGeer1,6, Leonard A. Mermel10, Manoj J. Mammen1,7, Paul Alexander1,8, Amy S. Arrington1,10, John Centofanti1,9, Giuseppe Citerio3,20, Bandar Baw3,1,2, Ziad A. Memish3,21, Naomi Hammond3,6,4, Frederick G. Hayden3,7, Laura Evans3,8, Andrew Rhodes22,10
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
2Department of Medicine, McMaster University, Hamilton, Canada
3Copenhagen University Hospital Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark.
4Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)
5Conflicts of Interest: Dr. Yaseen Arabi is the principal investigator on a clinical trial for lopinavir/ritonavir and interferon in Middle East respiratory syndrome (MERS) and he was a nonpaid consultant on antiviral active for MERS-coronavirus (CoV) for Gilead Sciences and SAB Biotherapeutics. He is an investigator on REMAP-CAP trial and is a Board Members of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). Dr. Eddy Fan declared receiving consultancy fees from ALung Technologies and MC3 Cardiopulmonary. Dr. Maurizio Cecconi declared consultancy work with Edwards Lifesciences, Directed Systems, and Cheetah Medical. Dr. Lennie Derde is the NVIC (Dutch National ICU society) chair of Taskforce Infectious Diseases (standing committee), member of ESICM Coronavirus Taskforce (started with this outbreak), chair ESICM Clinical Training Committee, all are unpaid positions. Dr. Frederick Hyden is non-compensated consultant to Gilead Sciences (antivirals for RVIS including remdesivir), Regeneraon (monoclonals for RVIs including MERS), and SAB Biotherapeutics (polyclonal antibodies for RVIs including MERS). The remaining authors have disclosed that they have no potential conflicts of interest.
6Intensive Care Department, Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
7Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System/Albert Einstein College of Medicine, Bronx, New York, USA
8Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
9Rhode Island Hospital, Providence, Rhode Island USA;
10Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA
11Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, The Netherlands
12Department of Pharmacy, New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York, USA
13Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
14Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
15Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
16Critical Care Medicine Department, National Institutes of Health Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, USA
17Faculty of Medicine, Imperial College, London, UK
18Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
19Microbiology and Infection Control, St George’s University Hospitals NHS Foundation Trust & St George’s University of London, London, UK
20Department of Medicine and Surgery, Milano-Bicocca University, Milano, Italy
21Director, Research & Innovation Centre, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
22Adult Critical Care, St. George’s University Hospitals NHS Foundation Trust, St. George’s University of London, London, UK

Tóm tắt

Background:The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed.Methods:We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using theGrading of Recommendations, Assessment, Development and Evaluation(GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations.Results:The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy.Conclusion:The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.

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Critical Care Medicine

Tập 48 Số 6

e440-e469

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