The Surviving Sepsis Campaign: Research Priorities for Coronavirus Disease 2019 in Critical Illness

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.

Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial

“…We determined continuous stopping boundaries using the Kim-DeMets alpha-spending approach, 26 with a Pocock superiority bound for efficacy and O'Brien-Fleming bound for futility. 17 Both bounds were binding, in the sense that recruitment was to stop once they were crossed, and was designed to allow for the best chance to stop early in case of shown superiority (aggressive upper bound), therefore enabling all subsequent patients to benefit from the intervention, and to minimise the risk of premature interruption of the meta-trial without reaching good evidence of futility (conservative lower bound).…”

“… 15 , 16 Awake prone positioning has been identified as a research priority by the Surviving Sepsis Research Committee. 17 …”

Myeloid phenotypes in severe COVID-19 predict secondary infection and mortality: a pilot study

“…The limited number of patients in the three clusters and their association with outcome warrant further confirmation. Nevertheless, the phenotypic characterization of the three clusters and their reciprocal differences are clear enough to suggest association with specific clinical courses and may be of some utility to select patients for innovative therapy [ 21 , 25 , 39 ].…”

The Surviving Sepsis Campaign: research priorities for the administration, epidemiology, scoring and identification of sepsis

“…Subcommittees were tasked with elaborating on their initial contributions, and are previously published [3,4]. Another document specifically addresses research priorities for Coronavirus Disease 2019 [5]. For this manuscript, subcommittees were tasked with generating expanded reviews of remaining questions.…”