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

Abstract

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 the Grading 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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Affiliated Institutions

• University of Ulsan KR
• Impact CA
• Copenhagen University Hospital DK
• Humanitas University IT
• University of Milano-Bicocca IT
• Montefiore Health System US
• St George's, University of London GB
• King Saud bin Abdulaziz University for Health Sciences SA
• University of Toronto CA
• Brown University US
• Edwards Lifesciences (Switzerland) CH
• National Guard Health Affairs SA
• United Arab Emirates University AE
• Rigshospitalet DK
• New York Hospital Queens US
• National Institute of Allergy and Infectious Diseases US
• Rhode Island Hospital US
• NewYork–Presbyterian Hospital US
• Utrecht University NL
• Gilead Sciences (Australia) AU
• National Institutes of Health Clinical Center US
• Ministry of Health SA
• Columbia University US
• Ulsan College KR
• Imperial College London GB
• Albert Einstein College of Medicine US
• University Medical Center Utrecht NL
• King Saud Medical City SA
• McMaster University CA
• St George’s University Hospitals NHS Foundation Trust GB
• King Abdullah International Medical Research Center SA
• Society of Critical Care Medicine US
• Asan Medical Center KR

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