Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update.
Identifieur interne : 000368 ( Main/Corpus ); précédent : 000367; suivant : 000369Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update.
Auteurs : Waleed Alhazzani ; Laura Evans ; Fayez Alshamsi ; Morten Hylander M Ller ; Marlies Ostermann ; Hallie C. Prescott ; Yaseen M. Arabi ; Mark Loeb ; Michelle Ng Gong ; Eddy Fan ; Simon Oczkowski ; Mitchell M. Levy ; Lennie Derde ; Amy Dzierba ; Bin Du ; Flavia Machado ; Hannah Wunsch ; Mark Crowther ; Maurizio Cecconi ; Younsuck Koh ; Lisa Burry ; Daniel S. Chertow ; Wojciech Szczeklik ; Emilie Belley-Cote ; Massimiliano Greco ; Malgorzata Bala ; Ryan Zarychanski ; Jozef Kesecioglu ; Allison Mcgeer ; Leonard Mermel ; Manoj J. Mammen ; Sheila Nainan Myatra ; Amy Arrington ; Ruth Kleinpell ; Giuseppe Citerio ; Kimberley Lewis ; Elizabeth Bridges ; Ziad A. Memish ; Naomi Hammond ; Frederick G. Hayden ; Muhammed Alshahrani ; Zainab Al Duhailib ; Greg S. Martin ; Lewis J. Kaplan ; Craig M. Coopersmith ; Massimo Antonelli ; Andrew RhodesSource :
- Critical care medicine [ 1530-0293 ] ; 2021.
English descriptors
- KwdEn :
- Adenosine Monophosphate (analogs & derivatives), Adenosine Monophosphate (therapeutic use), Adrenal Cortex Hormones (therapeutic use), Alanine (analogs & derivatives), Alanine (therapeutic use), Anticoagulants (MeSH), COVID-19 (therapy), Critical Care (MeSH), Dexamethasone (therapeutic use), Disease Management (MeSH), Evidence-Based Medicine (MeSH), Hemodynamics (MeSH), Humans (MeSH), Hydroxychloroquine (MeSH), Immunization, Passive (MeSH), Intensive Care Units (MeSH), Patient Positioning (MeSH), Practice Guidelines as Topic (MeSH), Ventilation (MeSH).
- MESH :
- chemical , analogs & derivatives : Adenosine Monophosphate, Alanine.
- chemical , therapeutic use : Adenosine Monophosphate, Adrenal Cortex Hormones, Alanine, Dexamethasone.
- chemical : Anticoagulants, Hydroxychloroquine.
- therapy : COVID-19.
- Critical Care, Disease Management, Evidence-Based Medicine, Hemodynamics, Humans, Immunization, Passive, Intensive Care Units, Patient Positioning, Practice Guidelines as Topic, Ventilation.
Abstract
BACKGROUND
The coronavirus disease 2019 pandemic continues to affect millions worldwide. Given the rapidly growing evidence base, we implemented a living guideline model to provide guidance on the management of patients with severe or critical coronavirus disease 2019 in the ICU.
METHODS
The Surviving Sepsis Campaign Coronavirus Disease 2019 panel has expanded to include 43 experts from 14 countries; all panel members completed an electronic conflict-of-interest disclosure form. In this update, the panel addressed nine questions relevant to managing severe or critical coronavirus disease 2019 in the ICU. We used the World Health Organization's definition of severe and critical coronavirus disease 2019. The systematic reviews team searched the literature for relevant evidence, aiming to identify systematic reviews and clinical trials. When appropriate, we performed a random-effects meta-analysis to summarize treatment effects. We assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach, then used the evidence-to-decision framework to generate recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility.
RESULTS
The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued nine statements (three new and six updated) related to ICU patients with severe or critical coronavirus disease 2019. For severe or critical coronavirus disease 2019, the panel strongly recommends using systemic corticosteroids and venous thromboprophylaxis but strongly recommends against using hydroxychloroquine. In addition, the panel suggests using dexamethasone (compared with other corticosteroids) and suggests against using convalescent plasma and therapeutic anticoagulation outside clinical trials. The Surviving Sepsis Campaign Coronavirus Diease 2019 panel suggests using remdesivir in nonventilated patients with severe coronavirus disease 2019 and suggests against starting remdesivir in patients with critical coronavirus disease 2019 outside clinical trials. Because of insufficient evidence, the panel did not issue a recommendation on the use of awake prone positioning.
CONCLUSION
The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued several recommendations to guide healthcare professionals caring for adults with critical or severe coronavirus disease 2019 in the ICU. Based on a living guideline model the recommendations will be updated as new evidence becomes available.
DOI: 10.1097/CCM.0000000000004899
PubMed: 33555780
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pubmed:33555780Le document en format XML
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<author><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
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<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
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<author><name sortKey="Evans, Laura" sort="Evans, Laura" uniqKey="Evans L" first="Laura" last="Evans">Laura Evans</name>
<affiliation><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Alshamsi, Fayez" sort="Alshamsi, Fayez" uniqKey="Alshamsi F" first="Fayez" last="Alshamsi">Fayez Alshamsi</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="M Ller, Morten Hylander" sort="M Ller, Morten Hylander" uniqKey="M Ller M" first="Morten Hylander" last="M Ller">Morten Hylander M Ller</name>
<affiliation><nlm:affiliation>Copenhagen University Hospital Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI).</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Ostermann, Marlies" sort="Ostermann, Marlies" uniqKey="Ostermann M" first="Marlies" last="Ostermann">Marlies Ostermann</name>
<affiliation><nlm:affiliation>Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Prescott, Hallie C" sort="Prescott, Hallie C" uniqKey="Prescott H" first="Hallie C" last="Prescott">Hallie C. Prescott</name>
<affiliation><nlm:affiliation>Department of Medicine, University of Michigan, Ann Arbor and VA Ann Arbor Healthcare System, Ann Arbor, MI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M" last="Arabi">Yaseen M. Arabi</name>
<affiliation><nlm:affiliation>Intensive 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.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Ng Gong, Michelle" sort="Ng Gong, Michelle" uniqKey="Ng Gong M" first="Michelle" last="Ng Gong">Michelle Ng Gong</name>
<affiliation><nlm:affiliation>Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System/Albert Einstein College of Medicine, The Bronx, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fan, Eddy" sort="Fan, Eddy" uniqKey="Fan E" first="Eddy" last="Fan">Eddy Fan</name>
<affiliation><nlm:affiliation>Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Oczkowski, Simon" sort="Oczkowski, Simon" uniqKey="Oczkowski S" first="Simon" last="Oczkowski">Simon Oczkowski</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Levy, Mitchell M" sort="Levy, Mitchell M" uniqKey="Levy M" first="Mitchell M" last="Levy">Mitchell M. Levy</name>
<affiliation><nlm:affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Rhode Island Hospital, Providence, RI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Derde, Lennie" sort="Derde, Lennie" uniqKey="Derde L" first="Lennie" last="Derde">Lennie Derde</name>
<affiliation><nlm:affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Dzierba, Amy" sort="Dzierba, Amy" uniqKey="Dzierba A" first="Amy" last="Dzierba">Amy Dzierba</name>
<affiliation><nlm:affiliation>Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name>
<affiliation><nlm:affiliation>State Key Laboratory of Complex, Severe, and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Machado, Flavia" sort="Machado, Flavia" uniqKey="Machado F" first="Flavia" last="Machado">Flavia Machado</name>
<affiliation><nlm:affiliation>Anaesthesiology, Pain and Intensive Care Department, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Wunsch, Hannah" sort="Wunsch, Hannah" uniqKey="Wunsch H" first="Hannah" last="Wunsch">Hannah Wunsch</name>
<affiliation><nlm:affiliation>Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Crowther, Mark" sort="Crowther, Mark" uniqKey="Crowther M" first="Mark" last="Crowther">Mark Crowther</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cecconi, Maurizio" sort="Cecconi, Maurizio" uniqKey="Cecconi M" first="Maurizio" last="Cecconi">Maurizio Cecconi</name>
<affiliation><nlm:affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Koh, Younsuck" sort="Koh, Younsuck" uniqKey="Koh Y" first="Younsuck" last="Koh">Younsuck Koh</name>
<affiliation><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Burry, Lisa" sort="Burry, Lisa" uniqKey="Burry L" first="Lisa" last="Burry">Lisa Burry</name>
<affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Chertow, Daniel S" sort="Chertow, Daniel S" uniqKey="Chertow D" first="Daniel S" last="Chertow">Daniel S. Chertow</name>
<affiliation><nlm:affiliation>Critical Care Medicine Department, National Institutes of Health Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Szczeklik, Wojciech" sort="Szczeklik, Wojciech" uniqKey="Szczeklik W" first="Wojciech" last="Szczeklik">Wojciech Szczeklik</name>
<affiliation><nlm:affiliation>Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Belley Cote, Emilie" sort="Belley Cote, Emilie" uniqKey="Belley Cote E" first="Emilie" last="Belley-Cote">Emilie Belley-Cote</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Population Health Research Institute, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Greco, Massimiliano" sort="Greco, Massimiliano" uniqKey="Greco M" first="Massimiliano" last="Greco">Massimiliano Greco</name>
<affiliation><nlm:affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bala, Malgorzata" sort="Bala, Malgorzata" uniqKey="Bala M" first="Malgorzata" last="Bala">Malgorzata Bala</name>
<affiliation><nlm:affiliation>Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zarychanski, Ryan" sort="Zarychanski, Ryan" uniqKey="Zarychanski R" first="Ryan" last="Zarychanski">Ryan Zarychanski</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kesecioglu, Jozef" sort="Kesecioglu, Jozef" uniqKey="Kesecioglu J" first="Jozef" last="Kesecioglu">Jozef Kesecioglu</name>
<affiliation><nlm:affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mermel, Leonard" sort="Mermel, Leonard" uniqKey="Mermel L" first="Leonard" last="Mermel">Leonard Mermel</name>
<affiliation><nlm:affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mammen, Manoj J" sort="Mammen, Manoj J" uniqKey="Mammen M" first="Manoj J" last="Mammen">Manoj J. Mammen</name>
<affiliation><nlm:affiliation>Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Nainan Myatra, Sheila" sort="Nainan Myatra, Sheila" uniqKey="Nainan Myatra S" first="Sheila" last="Nainan Myatra">Sheila Nainan Myatra</name>
<affiliation><nlm:affiliation>Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arrington, Amy" sort="Arrington, Amy" uniqKey="Arrington A" first="Amy" last="Arrington">Amy Arrington</name>
<affiliation><nlm:affiliation>Houston Children's Hospital, Baylor College of Medicine, Houston, TX.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kleinpell, Ruth" sort="Kleinpell, Ruth" uniqKey="Kleinpell R" first="Ruth" last="Kleinpell">Ruth Kleinpell</name>
<affiliation><nlm:affiliation>Vanderbilt University School of Nursing, Nashville, TN and Rush University College of Nursing, Chicago, IL.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Citerio, Giuseppe" sort="Citerio, Giuseppe" uniqKey="Citerio G" first="Giuseppe" last="Citerio">Giuseppe Citerio</name>
<affiliation><nlm:affiliation>School of Medicine and Surgery, Milano-Bicocca University, Milano, Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>ASST-Monza, San Gerardo Hospital, Monza, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lewis, Kimberley" sort="Lewis, Kimberley" uniqKey="Lewis K" first="Kimberley" last="Lewis">Kimberley Lewis</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bridges, Elizabeth" sort="Bridges, Elizabeth" uniqKey="Bridges E" first="Elizabeth" last="Bridges">Elizabeth Bridges</name>
<affiliation><nlm:affiliation>Biobehavioral Nursing and Health Informatics-University of Washington School of Nursing/University of Washington Medical Center, Seattle, WA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A" last="Memish">Ziad A. Memish</name>
<affiliation><nlm:affiliation>Director, Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hammond, Naomi" sort="Hammond, Naomi" uniqKey="Hammond N" first="Naomi" last="Hammond">Naomi Hammond</name>
<affiliation><nlm:affiliation>Critical Care Division, The George Institute for Global Health and UNSW, Sydney, NSW, Australia.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, NSW, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G" last="Hayden">Frederick G. Hayden</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, School of Medicine, Charlottesville, VA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Alshahrani, Muhammed" sort="Alshahrani, Muhammed" uniqKey="Alshahrani M" first="Muhammed" last="Alshahrani">Muhammed Alshahrani</name>
<affiliation><nlm:affiliation>Department of Emergency and Critical Care, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Al Duhailib, Zainab" sort="Al Duhailib, Zainab" uniqKey="Al Duhailib Z" first="Zainab" last="Al Duhailib">Zainab Al Duhailib</name>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Critical Care Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Martin, Greg S" sort="Martin, Greg S" uniqKey="Martin G" first="Greg S" last="Martin">Greg S. Martin</name>
<affiliation><nlm:affiliation>Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital, Atlanta, GA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kaplan, Lewis J" sort="Kaplan, Lewis J" uniqKey="Kaplan L" first="Lewis J" last="Kaplan">Lewis J. Kaplan</name>
<affiliation><nlm:affiliation>Perelman School of Medicine, University of Pennsylvania; Department of Surgery; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Philadelphia, PA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Coopersmith, Craig M" sort="Coopersmith, Craig M" uniqKey="Coopersmith C" first="Craig M" last="Coopersmith">Craig M. Coopersmith</name>
<affiliation><nlm:affiliation>Department of Surgery and Emory Critical Care center, Emory University School of Medicine, Atlanta, GA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name>
<affiliation><nlm:affiliation>Department of Anesthesiology Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rhodes, Andrew" sort="Rhodes, Andrew" uniqKey="Rhodes A" first="Andrew" last="Rhodes">Andrew Rhodes</name>
<affiliation><nlm:affiliation>Adult Critical Care, St George's University Hospitals NHS Foundation Trust & St George's University of London, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
</titleStmt>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update.</title>
<author><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Evans, Laura" sort="Evans, Laura" uniqKey="Evans L" first="Laura" last="Evans">Laura Evans</name>
<affiliation><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Alshamsi, Fayez" sort="Alshamsi, Fayez" uniqKey="Alshamsi F" first="Fayez" last="Alshamsi">Fayez Alshamsi</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="M Ller, Morten Hylander" sort="M Ller, Morten Hylander" uniqKey="M Ller M" first="Morten Hylander" last="M Ller">Morten Hylander M Ller</name>
<affiliation><nlm:affiliation>Copenhagen University Hospital Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI).</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Ostermann, Marlies" sort="Ostermann, Marlies" uniqKey="Ostermann M" first="Marlies" last="Ostermann">Marlies Ostermann</name>
<affiliation><nlm:affiliation>Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Prescott, Hallie C" sort="Prescott, Hallie C" uniqKey="Prescott H" first="Hallie C" last="Prescott">Hallie C. Prescott</name>
<affiliation><nlm:affiliation>Department of Medicine, University of Michigan, Ann Arbor and VA Ann Arbor Healthcare System, Ann Arbor, MI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arabi, Yaseen M" sort="Arabi, Yaseen M" uniqKey="Arabi Y" first="Yaseen M" last="Arabi">Yaseen M. Arabi</name>
<affiliation><nlm:affiliation>Intensive 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.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Ng Gong, Michelle" sort="Ng Gong, Michelle" uniqKey="Ng Gong M" first="Michelle" last="Ng Gong">Michelle Ng Gong</name>
<affiliation><nlm:affiliation>Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System/Albert Einstein College of Medicine, The Bronx, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fan, Eddy" sort="Fan, Eddy" uniqKey="Fan E" first="Eddy" last="Fan">Eddy Fan</name>
<affiliation><nlm:affiliation>Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Oczkowski, Simon" sort="Oczkowski, Simon" uniqKey="Oczkowski S" first="Simon" last="Oczkowski">Simon Oczkowski</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Levy, Mitchell M" sort="Levy, Mitchell M" uniqKey="Levy M" first="Mitchell M" last="Levy">Mitchell M. Levy</name>
<affiliation><nlm:affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Rhode Island Hospital, Providence, RI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Derde, Lennie" sort="Derde, Lennie" uniqKey="Derde L" first="Lennie" last="Derde">Lennie Derde</name>
<affiliation><nlm:affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Dzierba, Amy" sort="Dzierba, Amy" uniqKey="Dzierba A" first="Amy" last="Dzierba">Amy Dzierba</name>
<affiliation><nlm:affiliation>Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name>
<affiliation><nlm:affiliation>State Key Laboratory of Complex, Severe, and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Machado, Flavia" sort="Machado, Flavia" uniqKey="Machado F" first="Flavia" last="Machado">Flavia Machado</name>
<affiliation><nlm:affiliation>Anaesthesiology, Pain and Intensive Care Department, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Wunsch, Hannah" sort="Wunsch, Hannah" uniqKey="Wunsch H" first="Hannah" last="Wunsch">Hannah Wunsch</name>
<affiliation><nlm:affiliation>Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Crowther, Mark" sort="Crowther, Mark" uniqKey="Crowther M" first="Mark" last="Crowther">Mark Crowther</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cecconi, Maurizio" sort="Cecconi, Maurizio" uniqKey="Cecconi M" first="Maurizio" last="Cecconi">Maurizio Cecconi</name>
<affiliation><nlm:affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Koh, Younsuck" sort="Koh, Younsuck" uniqKey="Koh Y" first="Younsuck" last="Koh">Younsuck Koh</name>
<affiliation><nlm:affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Burry, Lisa" sort="Burry, Lisa" uniqKey="Burry L" first="Lisa" last="Burry">Lisa Burry</name>
<affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Chertow, Daniel S" sort="Chertow, Daniel S" uniqKey="Chertow D" first="Daniel S" last="Chertow">Daniel S. Chertow</name>
<affiliation><nlm:affiliation>Critical Care Medicine Department, National Institutes of Health Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Szczeklik, Wojciech" sort="Szczeklik, Wojciech" uniqKey="Szczeklik W" first="Wojciech" last="Szczeklik">Wojciech Szczeklik</name>
<affiliation><nlm:affiliation>Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Belley Cote, Emilie" sort="Belley Cote, Emilie" uniqKey="Belley Cote E" first="Emilie" last="Belley-Cote">Emilie Belley-Cote</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Population Health Research Institute, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Greco, Massimiliano" sort="Greco, Massimiliano" uniqKey="Greco M" first="Massimiliano" last="Greco">Massimiliano Greco</name>
<affiliation><nlm:affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bala, Malgorzata" sort="Bala, Malgorzata" uniqKey="Bala M" first="Malgorzata" last="Bala">Malgorzata Bala</name>
<affiliation><nlm:affiliation>Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zarychanski, Ryan" sort="Zarychanski, Ryan" uniqKey="Zarychanski R" first="Ryan" last="Zarychanski">Ryan Zarychanski</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kesecioglu, Jozef" sort="Kesecioglu, Jozef" uniqKey="Kesecioglu J" first="Jozef" last="Kesecioglu">Jozef Kesecioglu</name>
<affiliation><nlm:affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mermel, Leonard" sort="Mermel, Leonard" uniqKey="Mermel L" first="Leonard" last="Mermel">Leonard Mermel</name>
<affiliation><nlm:affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mammen, Manoj J" sort="Mammen, Manoj J" uniqKey="Mammen M" first="Manoj J" last="Mammen">Manoj J. Mammen</name>
<affiliation><nlm:affiliation>Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Nainan Myatra, Sheila" sort="Nainan Myatra, Sheila" uniqKey="Nainan Myatra S" first="Sheila" last="Nainan Myatra">Sheila Nainan Myatra</name>
<affiliation><nlm:affiliation>Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Arrington, Amy" sort="Arrington, Amy" uniqKey="Arrington A" first="Amy" last="Arrington">Amy Arrington</name>
<affiliation><nlm:affiliation>Houston Children's Hospital, Baylor College of Medicine, Houston, TX.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kleinpell, Ruth" sort="Kleinpell, Ruth" uniqKey="Kleinpell R" first="Ruth" last="Kleinpell">Ruth Kleinpell</name>
<affiliation><nlm:affiliation>Vanderbilt University School of Nursing, Nashville, TN and Rush University College of Nursing, Chicago, IL.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Citerio, Giuseppe" sort="Citerio, Giuseppe" uniqKey="Citerio G" first="Giuseppe" last="Citerio">Giuseppe Citerio</name>
<affiliation><nlm:affiliation>School of Medicine and Surgery, Milano-Bicocca University, Milano, Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>ASST-Monza, San Gerardo Hospital, Monza, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lewis, Kimberley" sort="Lewis, Kimberley" uniqKey="Lewis K" first="Kimberley" last="Lewis">Kimberley Lewis</name>
<affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bridges, Elizabeth" sort="Bridges, Elizabeth" uniqKey="Bridges E" first="Elizabeth" last="Bridges">Elizabeth Bridges</name>
<affiliation><nlm:affiliation>Biobehavioral Nursing and Health Informatics-University of Washington School of Nursing/University of Washington Medical Center, Seattle, WA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A" last="Memish">Ziad A. Memish</name>
<affiliation><nlm:affiliation>Director, Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hammond, Naomi" sort="Hammond, Naomi" uniqKey="Hammond N" first="Naomi" last="Hammond">Naomi Hammond</name>
<affiliation><nlm:affiliation>Critical Care Division, The George Institute for Global Health and UNSW, Sydney, NSW, Australia.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, NSW, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hayden, Frederick G" sort="Hayden, Frederick G" uniqKey="Hayden F" first="Frederick G" last="Hayden">Frederick G. Hayden</name>
<affiliation><nlm:affiliation>Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, School of Medicine, Charlottesville, VA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Alshahrani, Muhammed" sort="Alshahrani, Muhammed" uniqKey="Alshahrani M" first="Muhammed" last="Alshahrani">Muhammed Alshahrani</name>
<affiliation><nlm:affiliation>Department of Emergency and Critical Care, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Al Duhailib, Zainab" sort="Al Duhailib, Zainab" uniqKey="Al Duhailib Z" first="Zainab" last="Al Duhailib">Zainab Al Duhailib</name>
<affiliation><nlm:affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Department of Critical Care Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Martin, Greg S" sort="Martin, Greg S" uniqKey="Martin G" first="Greg S" last="Martin">Greg S. Martin</name>
<affiliation><nlm:affiliation>Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital, Atlanta, GA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kaplan, Lewis J" sort="Kaplan, Lewis J" uniqKey="Kaplan L" first="Lewis J" last="Kaplan">Lewis J. Kaplan</name>
<affiliation><nlm:affiliation>Perelman School of Medicine, University of Pennsylvania; Department of Surgery; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Philadelphia, PA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Coopersmith, Craig M" sort="Coopersmith, Craig M" uniqKey="Coopersmith C" first="Craig M" last="Coopersmith">Craig M. Coopersmith</name>
<affiliation><nlm:affiliation>Department of Surgery and Emory Critical Care center, Emory University School of Medicine, Atlanta, GA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name>
<affiliation><nlm:affiliation>Department of Anesthesiology Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rhodes, Andrew" sort="Rhodes, Andrew" uniqKey="Rhodes A" first="Andrew" last="Rhodes">Andrew Rhodes</name>
<affiliation><nlm:affiliation>Adult Critical Care, St George's University Hospitals NHS Foundation Trust & St George's University of London, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
</analytic>
<series><title level="j">Critical care medicine</title>
<idno type="eISSN">1530-0293</idno>
<imprint><date when="2021" type="published">2021</date>
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<term>Alanine (analogs & derivatives)</term>
<term>Alanine (therapeutic use)</term>
<term>Anticoagulants (MeSH)</term>
<term>COVID-19 (therapy)</term>
<term>Critical Care (MeSH)</term>
<term>Dexamethasone (therapeutic use)</term>
<term>Disease Management (MeSH)</term>
<term>Evidence-Based Medicine (MeSH)</term>
<term>Hemodynamics (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (MeSH)</term>
<term>Immunization, Passive (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Patient Positioning (MeSH)</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>The coronavirus disease 2019 pandemic continues to affect millions worldwide. Given the rapidly growing evidence base, we implemented a living guideline model to provide guidance on the management of patients with severe or critical coronavirus disease 2019 in the ICU.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>The Surviving Sepsis Campaign Coronavirus Disease 2019 panel has expanded to include 43 experts from 14 countries; all panel members completed an electronic conflict-of-interest disclosure form. In this update, the panel addressed nine questions relevant to managing severe or critical coronavirus disease 2019 in the ICU. We used the World Health Organization's definition of severe and critical coronavirus disease 2019. The systematic reviews team searched the literature for relevant evidence, aiming to identify systematic reviews and clinical trials. When appropriate, we performed a random-effects meta-analysis to summarize treatment effects. We assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach, then used the evidence-to-decision framework to generate recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued nine statements (three new and six updated) related to ICU patients with severe or critical coronavirus disease 2019. For severe or critical coronavirus disease 2019, the panel strongly recommends using systemic corticosteroids and venous thromboprophylaxis but strongly recommends against using hydroxychloroquine. In addition, the panel suggests using dexamethasone (compared with other corticosteroids) and suggests against using convalescent plasma and therapeutic anticoagulation outside clinical trials. The Surviving Sepsis Campaign Coronavirus Diease 2019 panel suggests using remdesivir in nonventilated patients with severe coronavirus disease 2019 and suggests against starting remdesivir in patients with critical coronavirus disease 2019 outside clinical trials. Because of insufficient evidence, the panel did not issue a recommendation on the use of awake prone positioning.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued several recommendations to guide healthcare professionals caring for adults with critical or severe coronavirus disease 2019 in the ICU. Based on a living guideline model the recommendations will be updated as new evidence becomes available.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33555780</PMID>
<DateCompleted><Year>2021</Year>
<Month>03</Month>
<Day>04</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>05</Month>
<Day>05</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1530-0293</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>49</Volume>
<Issue>3</Issue>
<PubDate><Year>2021</Year>
<Month>03</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>Critical care medicine</Title>
<ISOAbbreviation>Crit Care Med</ISOAbbreviation>
</Journal>
<ArticleTitle>Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update.</ArticleTitle>
<Pagination><MedlinePgn>e219-e234</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1097/CCM.0000000000004899</ELocationID>
<Abstract><AbstractText Label="BACKGROUND">The coronavirus disease 2019 pandemic continues to affect millions worldwide. Given the rapidly growing evidence base, we implemented a living guideline model to provide guidance on the management of patients with severe or critical coronavirus disease 2019 in the ICU.</AbstractText>
<AbstractText Label="METHODS">The Surviving Sepsis Campaign Coronavirus Disease 2019 panel has expanded to include 43 experts from 14 countries; all panel members completed an electronic conflict-of-interest disclosure form. In this update, the panel addressed nine questions relevant to managing severe or critical coronavirus disease 2019 in the ICU. We used the World Health Organization's definition of severe and critical coronavirus disease 2019. The systematic reviews team searched the literature for relevant evidence, aiming to identify systematic reviews and clinical trials. When appropriate, we performed a random-effects meta-analysis to summarize treatment effects. We assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach, then used the evidence-to-decision framework to generate recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility.</AbstractText>
<AbstractText Label="RESULTS">The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued nine statements (three new and six updated) related to ICU patients with severe or critical coronavirus disease 2019. For severe or critical coronavirus disease 2019, the panel strongly recommends using systemic corticosteroids and venous thromboprophylaxis but strongly recommends against using hydroxychloroquine. In addition, the panel suggests using dexamethasone (compared with other corticosteroids) and suggests against using convalescent plasma and therapeutic anticoagulation outside clinical trials. The Surviving Sepsis Campaign Coronavirus Diease 2019 panel suggests using remdesivir in nonventilated patients with severe coronavirus disease 2019 and suggests against starting remdesivir in patients with critical coronavirus disease 2019 outside clinical trials. Because of insufficient evidence, the panel did not issue a recommendation on the use of awake prone positioning.</AbstractText>
<AbstractText Label="CONCLUSION">The Surviving Sepsis Campaign Coronavirus Diease 2019 panel issued several recommendations to guide healthcare professionals caring for adults with critical or severe coronavirus disease 2019 in the ICU. Based on a living guideline model the recommendations will be updated as new evidence becomes available.</AbstractText>
<CopyrightInformation>Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Alhazzani</LastName>
<ForeName>Waleed</ForeName>
<Initials>W</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Evans</LastName>
<ForeName>Laura</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alshamsi</LastName>
<ForeName>Fayez</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Møller</LastName>
<ForeName>Morten Hylander</ForeName>
<Initials>MH</Initials>
<AffiliationInfo><Affiliation>Copenhagen University Hospital Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI).</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ostermann</LastName>
<ForeName>Marlies</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Prescott</LastName>
<ForeName>Hallie C</ForeName>
<Initials>HC</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, University of Michigan, Ann Arbor and VA Ann Arbor Healthcare System, Ann Arbor, MI.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Arabi</LastName>
<ForeName>Yaseen M</ForeName>
<Initials>YM</Initials>
<AffiliationInfo><Affiliation>Intensive 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.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Loeb</LastName>
<ForeName>Mark</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ng Gong</LastName>
<ForeName>Michelle</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Division of Critical Care Medicine, Division of Pulmonary Medicine, Department of Medicine, Montefiore Healthcare System/Albert Einstein College of Medicine, The Bronx, NY.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fan</LastName>
<ForeName>Eddy</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Oczkowski</LastName>
<ForeName>Simon</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Levy</LastName>
<ForeName>Mitchell M</ForeName>
<Initials>MM</Initials>
<AffiliationInfo><Affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Rhode Island Hospital, Providence, RI.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Derde</LastName>
<ForeName>Lennie</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dzierba</LastName>
<ForeName>Amy</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Pharmacy, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.</Affiliation>
</AffiliationInfo>
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<ForeName>Bin</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>State Key Laboratory of Complex, Severe, and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.</Affiliation>
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<Initials>F</Initials>
<AffiliationInfo><Affiliation>Anaesthesiology, Pain and Intensive Care Department, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.</Affiliation>
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<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.</Affiliation>
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<AffiliationInfo><Affiliation>Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.</Affiliation>
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<ForeName>Mark</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
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<ForeName>Maurizio</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Koh</LastName>
<ForeName>Younsuck</ForeName>
<Initials>Y</Initials>
<AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Burry</LastName>
<ForeName>Lisa</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
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<ForeName>Daniel S</ForeName>
<Initials>DS</Initials>
<AffiliationInfo><Affiliation>Critical Care Medicine Department, National Institutes of Health Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD.</Affiliation>
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<Initials>W</Initials>
<AffiliationInfo><Affiliation>Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Belley-Cote</LastName>
<ForeName>Emilie</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Population Health Research Institute, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Greco</LastName>
<ForeName>Massimiliano</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Humanitas Clinical and Research Center-IRCCS, Rozzano (Mi), Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Humanitas University, Department of Biomedical Sciences, Milan, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bala</LastName>
<ForeName>Malgorzata</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Poland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zarychanski</LastName>
<ForeName>Ryan</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kesecioglu</LastName>
<ForeName>Jozef</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>McGeer</LastName>
<ForeName>Allison</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mermel</LastName>
<ForeName>Leonard</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Warren Alpert School of Medicine at Brown University, Providence, RI.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mammen</LastName>
<ForeName>Manoj J</ForeName>
<Initials>MJ</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Nainan Myatra</LastName>
<ForeName>Sheila</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Arrington</LastName>
<ForeName>Amy</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Houston Children's Hospital, Baylor College of Medicine, Houston, TX.</Affiliation>
</AffiliationInfo>
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<ForeName>Ruth</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Vanderbilt University School of Nursing, Nashville, TN and Rush University College of Nursing, Chicago, IL.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Citerio</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>School of Medicine and Surgery, Milano-Bicocca University, Milano, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>ASST-Monza, San Gerardo Hospital, Monza, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lewis</LastName>
<ForeName>Kimberley</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Bridges</LastName>
<ForeName>Elizabeth</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Biobehavioral Nursing and Health Informatics-University of Washington School of Nursing/University of Washington Medical Center, Seattle, WA.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Memish</LastName>
<ForeName>Ziad A</ForeName>
<Initials>ZA</Initials>
<AffiliationInfo><Affiliation>Director, Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hammond</LastName>
<ForeName>Naomi</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Critical Care Division, The George Institute for Global Health and UNSW, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Hayden</LastName>
<ForeName>Frederick G</ForeName>
<Initials>FG</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, School of Medicine, Charlottesville, VA.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Alshahrani</LastName>
<ForeName>Muhammed</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Emergency and Critical Care, Imam Abdulrahman Ben Faisal University, Dammam, Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Al Duhailib</LastName>
<ForeName>Zainab</ForeName>
<Initials>Z</Initials>
<AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Martin</LastName>
<ForeName>Greg S</ForeName>
<Initials>GS</Initials>
<AffiliationInfo><Affiliation>Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine and Grady Memorial Hospital, Atlanta, GA.</Affiliation>
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<Author ValidYN="Y"><LastName>Kaplan</LastName>
<ForeName>Lewis J</ForeName>
<Initials>LJ</Initials>
<AffiliationInfo><Affiliation>Perelman School of Medicine, University of Pennsylvania; Department of Surgery; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Philadelphia, PA.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Coopersmith</LastName>
<ForeName>Craig M</ForeName>
<Initials>CM</Initials>
<AffiliationInfo><Affiliation>Department of Surgery and Emory Critical Care center, Emory University School of Medicine, Atlanta, GA.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Antonelli</LastName>
<ForeName>Massimo</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Anesthesiology Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Rhodes</LastName>
<ForeName>Andrew</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Adult Critical Care, St George's University Hospitals NHS Foundation Trust & St George's University of London, London, United Kingdom.</Affiliation>
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<CoiStatement>Dr. Evans has disclosed that she is a PI on a multi-center observational cohort study of hospitalized patients with severe acute respiratory infection, funded by the CDC Foundation. Drs. Prescott, Chertow, and Mammen disclosed government work. Dr. Fan received funding from Lung Technologies, MC3 Cardiopulmonary, and Fresenius Medical Care. Dr. Derde’s institution received funding from ZonMw (Den Haag, Europe) grant number 10150062010003, the Canadian Institutes of Health Research (CIHR), and from Rapid European COVID-19 Emergency Research response (RECOVER) (Europe, H2020) grant agreement No 101003589, and her institution has agreements with Faron (interferon), SOBI (anakinra), and Abbvie (lopinavir/r) to supply drugs for the above-funded studies. Dr. Du’s institution received funding from the Ministry of Science and Technology for a COVID-19–related study (NCT04244591). Dr. Crowther received funding from Servier Canada, Asahi Kasei, Precision Biologicals, Hemostasis Reference Laboratory, Pfizer, CSL Behring, Diagnostica Stago, and he disclosed that he undertakes significant amounts of both medical malpractice and product work in the general areas of hematology and thromboembolism. Dr. Belley-Cote received funding from CIHR, Roche, and Bayer as a principal investigator for the ACT trial that evaluates hydroxychloroquine, interferon beta, colchicine, aspirin, and rivaroxaban in patients with COVID-19. Dr. Zarychanski received operating grants from CIHR, LifeArc Foundation, Thistledown Foundation, and Research Manitoba for grants related to anticoagulation in COVID-19. Dr. McGreer’s institution received funding from Appili Therapeutics. Dr. Hayden disclosed he is a nonpaid consultant for multiple companies involved in developing COVID-19 countermeasures (Arcturus, Cidara, Gilead, GSK, resTORbio, Regeneron, SAB Biotherapeutics, Takeda, Vir), and he is a DSMB member for CytoDyn. Dr. Martin received funding from serving on a clinical trial data monitoring board. Dr. Antonelli received funding from consulting for Intersurgical and ESTOR. Dr. Waleed Alhazzani is the principal investigator on awake proning trial in COVID-19 COVI-PRONE. 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). He is a co-investigator on the REMAP-CAP trial and on an awake proning trial in COVID-19 (COVI-PRONE). Dr. Maurizio Cecconi declared consultancy work with Edwards Lifesciences, Directed Systems, and Cheetah Medical: Dr. Lennie Derde is an investigator on REMAP-CAP trial, the NVIC (Dutch National ICU society) chair of Taskforce Infectious Diseases (standing committee), member of ESICM Coronavirus Taskforce (started with this outbreak), and chair of the ESICM Clinical Training Committee; all are unpaid positions. Dr. Laura Evans is the team leader for the critical care section of the NIH COVID-19 management guideline. Dr. Eddy Fan declared receiving consultancy fees from ALung Technologies and MC3 Cardiopulmonary. Dr. Frederick Hayden is a noncompensated consultant to Gilead Sciences, Regeneron, Cidara, Fujifilm, Ridgeback, Merck, Roche/Genentech, GSK, Vir, resTORbio, and SAB Biotherapeutics, and he is a DSMB member for CytoDyn therapeutic clinical trial: Dr. Manoj J. Mammen is an investigator for the U.S. NIH PASSive Immunity Trial for Our Nation (PassItOn) trial: Dr. Greg Martin is a member of the NIH COVID-19 treatment guidelines, principal investigator for COVID-19 diagnostic testing (U.S. NIH RADx program) and has served as a research consultant to Genentech, Grifols, Regeneron and Siemens. Dr. Massimo Antonelli declared consultancy with Toray/Estor and Fisher and Pykel and research grant from GE. Dr. Flavia Machado is member of the executive committee for the CODEX study. Dr. Sheila Nainan Myatra is on the steering committee of the COVID Steroid 2 Trial (ClinicalTrials.gov Identifier: NCT04509973) and the HydrOxychloroquine Prophylaxis Evaluation (HOPE) Trial (CTRI registration No.CTRI/2020/05/025067). Dr Naomi Hammond is on the steering committee of the COVID Steroid 2 Trial (ClinicalTrials.gov Identifier: NCT04509973) and the HydrOxychloroquine Prophylaxis Evaluation (HOPE) Trial (CTRI registration No.CTRI/2020/05/025067). Dr. Emilie Belley-Cote reports grants from Bayer, grants from Roche outside the submitted work. She is a principal investigator for the ACT trial: The remaining authors have disclosed that they do not have any potential conflicts of interest.</CoiStatement>
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