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 4 are best
practice statements, 9 are strong recommendations, and 35 are weak recommendations. No
recommendation was provided for 6 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.
