The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Alhazzani, Waleed; Alshahrani, Mohammed; Alshamsi, Fayez; Aljuhani, Ohoud; Eljaaly, Khalid; Hashim, Samaher; Alqahtani, Rakan; Alsaleh, Doaa; Al Duhailib, Zainab; Algethamy, Haifa; Al-Musawi, Tariq; Alshammari, Thamir; Alqarni, Abdullah; Khoujah, Danya; Tashkandi, Wail; Dahhan, Talal; Almutairi, Najla; Alserehi, Haleema A.; Al-Yahya, Maytha; Al-Judaibi, Bandar; Arabi, Yaseen M.; Abualenain, Jameel; Alotaibi, Jawaher M.; Al bshabshe, Ali; Alharbi, Reham; Al-Hameed, Fahad; Elhazmi, Alyaa; Almaghrabi, Reem S.; Almaghlouth, Fatma; Abedalthagafi, Malak; Al Khathlan, Noor; Al-Suwaidan, Faisal A.; Bunyan, Reem F.; Baw, Bandar; Alghamdi, Ghassan; Al Hazmi, Manal; Mandourah, Yasser; Assiri, Abdullah; Enani, Mushira; Alawi, Maha; Aljindan, Reem; Aljabbary, Ahmed; Alrbiaan, Abdullah; Algurashi, Fahd; Alsaawi, Abdulmohsen; Alenazi, Thamer H.; Alsultan, Mohammed A.; Alqahtani, Saleh A.; Memish, Ziad; Al-Tawfiq, Jaffar A.; Al-jedai, Ahmed;
• Is Part Of: Journal of infection and public health. Volume 15:Issue 1(2022)
• Page Start: 142
• Page End: 151
• Publication Date: 2022-01
• Subjects: ARDS acute respiratory distress syndrome -- CI confidence interval -- CrI credible interval -- CRP C-reactive protein -- EtD evidenced to decision -- GDT guideline development tool -- GRADE Grading of Recommendations, Assessment, Development and Evaluation -- GUIDE guidelines in intensive care, development, and evaluation -- HR hazard ratio -- HCQ hydroxychloroquine -- HFNC high flow nasal cannula -- ICU intensive care unit -- IDSA Infectious Disease Society of America -- MI myocardial infarction -- NIH National Institute of Health -- NIV noninvasive ventilation -- OR odds ratio -- PE pulmonary embolism -- RCT randomized controlled trials -- RdRP RNA-dependent RNA polymerase -- RR relative risk -- SCCS Saudi Critical Care Society -- WHO World Health Organization; COVID-19 -- Therapy -- Practice guideline -- Intensive care unit; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2021.10.005
• Languages: English
• ISSNs: 1876-0341

Abstract

Abstract: 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.