Journal of Infection and Public Health (Jan 2022)
The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section
- 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
Affiliations
- Waleed Alhazzani
- Department of Medicine, McMaster University, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada; GUIDE Center, St. Joseph’s Healthcare Hamilton, Hamilton, Canada; Corresponding author at: Department of Medicine, McMaster University, Canada.
- Mohammed Alshahrani
- Department of Emergency and Critical Care, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Fayez Alshamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Khalid Eljaaly
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Samaher Hashim
- Department of Medicine, University of Tabuk, Tabuk, Saudi Arabia
- Rakan Alqahtani
- Department of Critical Care Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Doaa Alsaleh
- Department of Population Health Science and Policy, Icahn’s School of Medicine at Mount Sinai, NYC, USA; King Abdullah International Medical Research Center, NGHA, Riyadh, Saudi Arabia
- Zainab Al Duhailib
- Critical Care Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Haifa Algethamy
- Department of Anesthesia and Critical Care, King Abdulaziz University, Jeddah, Saudi Arabia
- Tariq Al-Musawi
- Department of Critical Care Medicine, Dr Sulaiman AlHabib Hospital, AlKhobar, Saudi Arabia; Royal College of Surgeons in Ireland- Medical University of Bahrain, Bahrain
- Thamir Alshammari
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia; College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
- Abdullah Alqarni
- Department of Emergencies, Disasters, and Medical Transportation, Ministry of Health, Riyadh, Saudi Arabia
- Danya Khoujah
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Wail Tashkandi
- Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Critical Care, Fakeeh Care Group, Jeddah, Saudi Arabia
- Talal Dahhan
- Critical Care Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Duke University, Durham, USA
- Najla Almutairi
- Department of Emergencies, Disasters, and Medical Transportation, Ministry of Health, Riyadh, Saudi Arabia
- Haleema A. Alserehi
- Saudi Public Health Authority, Riyadh, Saudi Arabia
- Maytha Al-Yahya
- Department of Emergency Medicine, King AbdulAziz Medical City (KAMC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Bandar Al-Judaibi
- Transplant Division, University of Rochester, USA
- Yaseen M. Arabi
- King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Jameel Abualenain
- Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Jawaher M. Alotaibi
- Department of Medicine, King Faisal Specialist Hospital and Research Center Riyadh, Saudi Arabia
- Ali Al bshabshe
- Department of Medicine/Adult Critical Care, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Reham Alharbi
- Critical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Fahad Al-Hameed
- Department of Intensive Care, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Alyaa Elhazmi
- Dr. Sulaiman Al-Habib Medical Group, Critical Care Department, Riyadh, Saudi Arabia
- Reem S. Almaghrabi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Saudi Arabia
- Fatma Almaghlouth
- Respiratory Care Department, Faculty of Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Malak Abedalthagafi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
- Noor Al Khathlan
- Respiratory Care Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Faisal A. Al-Suwaidan
- Clinical Excellence Administration and King Fahad Medical City, Second Health Cluster in Riyadh, Ministry of Health, Saudi Arabia
- Reem F. Bunyan
- Center for Improving Value in Health, Saudi Arabia; Department of Neurology, King Fahad Specialist Hospital Dammam, Saudi Arabia
- Bandar Baw
- Department of Medicine, McMaster University, Canada; Department of Emergency Medicine, King AbdulAziz Medical City (KAMC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Ghassan Alghamdi
- Department of Medicine and Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Manal Al Hazmi
- Department of Medicine, King Fahad Specialist-Dammam, E1 Cluster, Dammam, Saudi Arabia
- Yasser Mandourah
- General Directorate of Military Medical Services, Ministry of Defense, Saudi Arabia
- Abdullah Assiri
- Infection Prevention and Control, Ministry of Health, Riyadh, Saudi Arabia
- Mushira Enani
- Section of Infectious Diseases Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
- Maha Alawi
- Department of Medical Microbiology, Parasitology, Infection Control and Environmental Health Unit, King Abdulaziz Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
- Reem Aljindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Ahmed Aljabbary
- Department of Intensive Care, Security Forces Hospital Program in Riyadh, Saudi Arabia
- Abdullah Alrbiaan
- Critical Care Medicine Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Fahd Algurashi
- Division of Anesthesia and Critical Care, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Abdulmohsen Alsaawi
- Department of Emergency Medicine, King AbdulAziz Medical City (KAMC), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Thamer H. Alenazi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard–Health Affairs, Riyadh, Saudi Arabia
- Mohammed A. Alsultan
- Saudi Commission for Health Specialities, Riyadh, Saudi Arabia
- Saleh A. Alqahtani
- Liver Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, USA
- Ziad Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, & College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Jaffar A. Al-Tawfiq
- Infectious Disease Division, Indiana University School of Medicine, IN, USA; Infectious Disease Division, Johns Hopkins University School of Medicine, Baltimore, USA; Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Ahmed Al-jedai
- Colleges of Medicine and Pharmacy, Alfaisal University, Riyadh, Saudi Arabia; Therapeutic Affairs, Ministry of Health, Riyadh, Saudi Arabia
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 142 – 151
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.
