Craig M Coopersmith1, Massimo Antonelli2, Seth R Bauer3, Clifford S Deutschman4,5, Laura E Evans6, Ricard Ferrer7, Judith Hellman8, Sameer Jog9, Jozef Kesecioglu10, Niranjan Kissoon11, Ignacio Martin-Loeches12,13, Mark E Nunnally14, Hallie C Prescott15, Andrew Rhodes16, Daniel Talmor17, Pierre Tissieres18, Daniel De Backer19. 1. Department of Surgery and Emory Critical Care Center, Emory University, Atlanta, GA. 2. Department of Anesthesiology Intensive Care and Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Italy. 3. Department of Pharmacy, Cleveland Clinic, Cleveland, OH. 4. Department of Pediatrics, Cohen Children's Medical center, Northwell Health, New Hyde Park, NY. 5. Feinstein Institute for Medical Research/Elmezzi Graduate School of Molecular Medicine, Manhasset, NY. 6. Department of Medicine, University of Washington, Seattle, WA. 7. Department of Intensive Care, SODIR-VHIR Research Group, Vall d'Hebron University Hospital, Barcelona, Spain. 8. Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA. 9. Department of Intensive Care Medicine, Deenanath Mangeshkar Hospital, Pune, India. 10. Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. 11. Department of Pediatrics and Emergency Medicine, University of British Columbia, Vancouver, BC, Canada. 12. Multidisciplinary Intensive Care Research Organization (MICRO), Department of Intensive Care Medicine, St. James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland. 13. Hospital Clinic, IDIBAPS, Universided de Barcelona, CIBERes, Barcelona, Spain. 14. Departments of Anesthesiology, Perioperative Care and Pain Medicine, Neurology, Surgery and Medicine, New York University, New York, NY. 15. Department of Medicine, University of Michigan and VA Center for Clinical Management Research, Ann Arbor, MI. 16. St George's University Hospitals NHS Foundation Trust and St George's University of London, London, United Kingdom. 17. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA. 18. Pediatric Intensive Care, AP-HP Paris Saclay University, Le Kremlin-Bicetre and Institute of Integrative Biology of the Cell, CNRS, CEA, Paris-Saclay University, Gif-sur-Yvette, France. 19. Chirec Hospitals, Université Libre de Bruxelles, Brussels, Belgium.
Abstract
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.
OBJECTIVES: To identify research priorities in the management, pathophysiology, and host response of coronavirus disease 2019 in critically illpatients. 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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