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The Surviving Sepsis Campaign: Research Priorities for Coronavirus Disease 2019 in Critical Illness
Craig M Coopersmith1, Massimo Antonelli2, Seth R Bauer3
1Department of Surgery and Emory Critical Care Center, Emory University, Atlanta, GA.
Insights
This study identified key research priorities for managing critically ill patients with coronavirus disease 2019 (COVID-19). Top priorities include optimizing ventilator management and understanding the host response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Area of Science:
- Critical care medicine
- Infectious diseases
- Respiratory medicine
Background:
- Coronavirus disease 2019 (COVID-19) presents significant challenges in critical care.
- Understanding pathophysiology and host response is crucial for effective management.
- Knowledge gaps persist despite rapid advancements during the pandemic.
Purpose of the Study:
- To identify and prioritize research areas for COVID-19 in critically ill patients.
- To guide future research efforts in disease management and treatment.
Main Methods:
- A multiprofessional committee of 17 international experts was convened virtually.
- Experts submitted and voted on research questions to determine top priorities.
- The Surviving Sepsis Research Committee iteratively developed recommendations.
Main Results:
- Thirteen research priorities for COVID-19 were identified.
- Top six priorities include ventilator management, host response modulation, cellular targets of SARS-CoV-2, outcome prediction, noninvasive ventilation/prone positioning, and viral load modulation.
- Specific questions address optimizing care for acute hypoxic respiratory failure.
Conclusions:
- Significant knowledge gaps remain in COVID-19 critical care.
- The identified research priorities provide a roadmap for future investigations.
- Further research is essential to improve outcomes for critically ill COVID-19 patients.
Objectives:
To identify research priorities in the management, pathophysiology, and host response of coronavirus disease 2019 in critically ill patients.
Design:
The Surviving Sepsis Research Committee, a multiprofessional group of 17 international experts representing the European Society of Intensive Care Medicine and Society of Critical Care Medicine, was virtually convened during the coronavirus disease 2019 pandemic. The committee iteratively developed the recommendations and subsequent document.
Methods:
Each committee member submitted a list of what they believed were the most important priorities for coronavirus disease 2019 research. The entire committee voted on 58 submitted questions to determine top priorities for coronavirus disease 2019 research.
Results:
The Surviving Sepsis Research Committee provides 13 priorities for coronavirus disease 2019. Of these, the top six priorities were identified and include the following questions: 1) Should the approach to ventilator management differ from the standard approach in patients with acute hypoxic respiratory failure?, 2) Can the host response be modulated for therapeutic benefit?, 3) What specific cells are directly targeted by severe acute respiratory syndrome coronavirus 2, and how do these cells respond?, 4) Can early data be used to predict outcomes of coronavirus disease 2019 and, by extension, to guide therapies?, 5) What is the role of prone positioning and noninvasive ventilation in nonventilated patients with coronavirus disease?, and 6) Which interventions are best to use for viral load modulation and when should they be given?
Conclusions:
Although knowledge of both biology and treatment has increased exponentially in the first year of the coronavirus disease 2019 pandemic, significant knowledge gaps remain. The research priorities identified represent a roadmap for investigation in coronavirus disease 2019.
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