The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section

Published on
Journal: Journal of infection and public health
[저자] Waleed Alhazzani, Mohammed Alshahrani, Fayez Alshamsi, Ohoud Aljuhani, Khalid Eljaaly, Samaher Hashim, Rakan Alqahtani, Doaa Alsaleh, Zainab Al Duhailib, Haifa Algethamy, Tariq Al-Musawi, Thamir Alshammari, Abdullah Alqarni, Danya Khoujah, Wail Tashkandi, Talal Dahhan, Najla Almutairi, Haleema A. Alserehi, Maytha Al-Yahya, Bandar Al-Judaibi, Yaseen M. Arabi, Jameel Abualenain, Jawaher M. Alotaibi, Ali Al bshabshe, Reham Alharbi, Fahad Al-Hameed, Alyaa Elhazmi, Reem S. Almaghrabi, Fatma Almaghlouth, Malak Abedalthagafi, Noor Al Khathlan, Faisal A. Al-Suwaidan, Reem F. Bunyan, Bandar Baw, Ghassan Alghamdi, Manal Al Hazmi, Yasser Mandourah, Abdullah Assiri, Mushira Enani, Maha Alawi, Reem Aljindan, Ahmed Aljabbary, Abdullah Alrbiaan, Fahd Algurashi, Abdulmohsen Alsaawi, Thamer H. Alenazi, Mohammed A. Alsultan, Saleh A. Alqahtani, Ziad Memish, Jaffar A. Al-Tawfiq, Ahmed Al-jedai
[Category] MERS, SARS,
PMC URL    Pubmed URL    [DOI] 10.1016/j.jiph.2021.10.005    
[Article Type] Original Article
[Source] PMC

Background The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). Methods The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. Results The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. Conclusion The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available.

All Keywords
【저자키워드】 COVID-19, therapy, intensive care unit, OR, odds ratio, RdRp, RNA-dependent RNA polymerase, ARDS, acute respiratory distress syndrome, WHO, World Health Organization, CI, Confidence interval, ICU, Intensive care unit, CRP, C-reactive protein, HR, hazard ratio, HCQ, hydroxychloroquine, practice guideline, RR, relative risk, MI, myocardial infarction, PE, Pulmonary embolism, NIH, National Institute of health, CrI, credible interval, EtD, evidenced to decision, GDT, guideline development tool, GRADE, Grading of Recommendations, Assessment, Development and Evaluation, GUIDE, guidelines in intensive care, development, and evaluation, HFNC, high flow nasal cannula, IDSA, Infectious Disease Society of America, NIV, noninvasive ventilation, RCT, randomized controlled trials, SCCS, Saudi Critical Care Society,