COVID-19 Critical Care Resources

This website aims to provide reliable up-to-date resources, but with the rapid changes in this situation and the numerous incorrect resources, this cannot always be guaranteed. Older links are archived - see bottom of page

ICU Management of COVID: overviews and guidelines

Management Principles of Adult Critically Ill COVID-19 Patients - UoT IDCCM, May 24

Brigham & Womens's Hospital COVID-19 Critical Care Clinical Guidelines 

Massachusetts General Hospital COVID-19 Treatment Guidance,

Care of the Adult Critically ill COVID-19 Patient: Alberta Health Services


NEW!!

Thrombosis & thromboprophylaxis in COVID-19 pregnancy, AOGS, July 17
Airborne transmission of COVID-19, JAMA July 13
      - Twitter thread discussing/refuting above
COVID-19 neurological effects, Brain, July 8
Increased risk of COVID-19 in PPI users, AJG, July 7
Fan et al, COVID-19 ARDS:  Lancet Respir Med, July 6

Dexamethasone in COVID-19 (RECOVERY trial) (preprint, June 22), NEJM July 17

Systematic review and meta analysis of COVID-19 in pregnancy, Lancet E-Clinical Med, June 2020

COVID in pregnancy in the UK: national cohort study, BMJ, June 8


Quick ICU Training for COVID-19 for non-intensivists

Resources & Links

CANADIAN
EmergentC: website providing curated clinical knowledge about COVID-19
Univeristy Health Network, Toronto, PPE for aerosol generating procedures - YouTube
COVIDCRITICALCARE
Ventilation of COVID : Toronto Critical Care resources (Laurent Brochard)
Canadian Anesthesiologists' Society Intubation Guidelines for #COVID19
Government of Canada: COVID-19 for health professionals
Government of Canada: Infection Preventiona and Control for COVID-19
Critical Care Services Ontario: Surge capacity management
Ontario MOHLTC guideance
Public Health Ontario, COVID-19
Pandemic triage, Mike Christian, Crit Care Clinics, 2019
COVID-19 ICU intubation procedure (Sinai, Toronto)

INTERNATIONAL
ICS Safety Alert: High Flow O2 and hospital infrastructure
ISTH Thrombosis in COVID - Webinar
Twitter thread: COVID in NYC, clinical charactersitics and management
Ventilating 2 patients on one ventilator: Columbia University, March 24th
Surviving Sepsis Guidelines COVID-19 management synopsis, March 26
ANZICS Guidelines for COVID-19, March 16th
Royal College of Anaesthetists U.K - COVID-19 resources
SCCM COVID-19 Preparedness Checklist
SCCM COVID-19 Resources
COVID-19: National University of Singapore
CDC COVID-19 resources
WHO COVID-19 updates

COVID-19 live updates

John Hopkins COVID-19 Global dashboard
 

WHO COVID19 situation map
WHO map

Worldometers COVID-19

COVID-19 in Ontario, Canada

Ontario Dashboard

COVID-19 in Pregnancy

Thrombosis and thromboprophylaxis in COVID-19 pregnancy, AOGS, July 17
Including pregnant women in clinical trials of COVID-19, Ann Int Med, June 29
CDC data on COVID-19 in pregnant women, June 25
Maternal mortality of COVID-19 in pregnant patients admitted to ICU in NY, Am J Obstet Gynecol, June 15
Systematic review and meta analysis of COVID-19 in pregnancy, Lancet E-Clinical Med, June 2020
Prone positioning in pregnancy - an algorithm, Obstet Gynecol, June 9
COVID in pregnancy in the UK: national cohort study, BMJ, June 8
Obstetric patients with COVID-19, New York. Obets Gynecol, May 27
Universal testing of OB patients in NY, AJOG MFM, May 15
Placental pathology in COVID, AJCP  May 22
Special supplement, COVID and pregnancy, AJOG, May 2020
Delivery for pregnant women with COVID respiratory compromise, AJOG, May 23
Case series 46 pregnant women in Washington State, AJOG May 17
UKOSS report: COVID in pregnancy, May 11
Postpartum exacerbation of COVID, CMAJ May 6
Maternal death due to COVID, ACOG, Apr 28
Scoping review of COVID in pregnancy, Int J Obstet Gynecol, April 24
COVID in pregnancy: 118 women from Wuhan, NEJM April 17
Classification of maternal-fetal-neonatal COVID disease, AOGS, April 11
Prone positioning in pregnancy, BMC Preg Childbirth, 2018
Risks of COVID Treatment in pregnancy
Systematic review of maternal & perinatal outcomes: 108 patients, AOGS, April  7
Care of pregnant women in labour and delivery, AJOG April 10
ACOG Statement: recent developments with COVID, April 6
COVID-19 in pregnant women: report on 43 pregnant women from NY, AJOG, April 6
COVID in pregnancy, review, AJOG, April 5
Perinatal aspects of COVID-19, J Perinatology, March 26
RCOG: Guide for Maternal Medicine, March 30
RCOG Q&A's for pregnant women & COVID, March 28
RCOG update: March 28
Pregnancy and COVID-19: REVIEW (March 21)
RCOG COVID Maternity eLearning package
COVID in pregnant women (update), Lancet March 17
Pregnancy & breastfeeding - CDC, March 17
Anesthetic regimens for Cesarean delivery - 17 patients, Can J Anesth, March 16
Coronavirus in pregnancy, Obstet Gynecol March 16th
Royal College of Anaesthetists: COVID-19 in pregnancy
RCOG: COVID-19 and pregnancy - update March 13th
CDC Guideline on COVID-19 in Inpatient Obstetric settings, March 11
Obstetric Anaesthetists Association statement on COVID-19, March 9th
Guidelines for pregnant women with COVID-19, Lancet March 3 2020
           Algorithm for pregnant women with COVID-19
ACOG Practice advisory - COVID-19
Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. AJOG, Feb 24, 2020
WHO: Clinical management of COVID-19, Jan 28th (includes Pediatric & Obstetric patients)


Recently published Literature

Thrombosis and thromboprophylaxis in COVID-19 pregnancy, AOGS, July 17
Airborne transmission of COVID-19, JAMA July 13
    - Twitter thread discussing/refuting above
COVID-19 neurological effects, Brain, July 8
Increased risk of COVID-19 in PPI users, AJG, July 7
Fan et al, COVID-19 ARDS:  Lancet Respir Med, July 6
"Cytokine storm" and COVID-19, JAMA, June 30
Sensitivity of NP swabs and saliva in COVID-19 testing, Clin Inf Dis, June 25
Dexamethasone in COVID-19 (RECOVERY trial) (preprint, June 22), NEJM July 17
RECOVERY trial dexamethasone Press release, June 17
     RECOVERY trial protocol
     RECOVERY trial statistical analysis plan
Systematic review and meta analysis of COVID-19 in pregnancy, Lancet E-Clinical Med, June 2020
Prone positioning in pregnancy - an algorithm, Obstet Gynecol, June 9
COVID in pregnancy in the UK: national cohort study, BMJ, June 8
UK Recovery trial on hydroxychloroquine, online results June 5
RCT of hydroxychloroquine for post-exposure prophylaxis, NEJM June 3
Chest guidelines on VTED & COVID-19, June 2
Tracheal intubation in patients with COVID-19, CMAJ, June 1
Routine VTE prophylaxis in COVID-19 in inadequate, CCM, May 27
VTE and COVID - narrative review, JTH, May 27
Period of infectivity with COVID-19, Singapore NCID, May 23
Delivery for pregnant women with COVID respiratory compromise, AJOG, May 23
Remdesivir treatment RCT, NEJM, May 22
COVID physiology: respiratory mechanics and gas exchange (New York), Ann ATS, May 20
Tracheostomy and COVID, Lancet May 15
Prone positioning & spontaneous breathing (Edit), JAMA May 15
Subphenotyping COVID ARDS, Ann ATS, May 11
UKOSS report: COVID in pregnancy, May 11
RCT of interferon, Kaletra, ribavirin in COVID, Lancet, May 8
Pulmonary intravascular coagulopathy of COVID, Lancet, May 7
Maternal death due to COVID, ACOG, Apr 28
Steroid treatment for COVID ARDS, Crit Care Explor, April
Management of respiratory failure in COVID, BMJ, May 4
High incidence of thrombosis in COVID, Thromb Res, April 30
COVID update: vascular dysfunction v inflammatory, ICM April 28
Remdesevir RCT from China, Lancet April 29
Physiology of COVID ARDS (Boston), AJRCCM April 29
COVID ARDS physiology and subphenotypes, Ann ATS, Apr 26
Scoping review of COVID in pregnancy, Int J Obstet Gynecol, April 24
Tocilizumab case report: lack of beneficial effect, Chest, April 25
 Thrombolytic drugs to treat COVID-19, JTH April 23
Autopsy lung pathology, Intensive Care Med April 23
Airborne transmission - a narrative review, Anaesthesia, April 20
COVID and ACE inhibitors in inpatients, JACC, April 17
COVID in pregnancy: 118 women from Wuhan, NEJM April 17
COVID Thrombotic disease - State of the Art review, JACC April 15
COVID pneumonia phenotypres, Critical Care, April 16
COVID phenotypes and mechanical ventilation. Gattinoni et al, ICM, April 14
Review of pharmacologic treatment of COVID-19, JAMA, April 13
Mechanical ventilation and COVID-19, Martin Tobin, AJRCCM, April 13
Universal screening of women admitted for delivery, NEJM April 13
Outcome of CPR in COVID-19, Resuscitation (proof, Apr 6)
Pulmonary adncardiac pathology on autopsy, New Orlean (preprint)
Protecting healthcare workers, Nava et al, Europ Resp Rev, April 6
Report on 1592 ICU patients in Lombardy, JAMA April 6
COVID-19 in pregnant women: report on 43 pregnant women from NY, AJOG, April 6
ICNARC report on 2204 patients, April 3
COVID phenotypes and mechanical ventilation (Gattinoni), ICM April 3
COVID ARDS by Gattinoni et al, AJRCCM, March 30
Palliative Care in COVID, CMAJ, March 31
Airway management during COVID, CJEM, March 30
ICNARC report on first 775 cases in U.K., March 27
Cardiac involvement with #COVID-19, JAMA March 27
End of life care for COVID-19 in the Emergency Room, Can J Emerg Med, March 26
Case fatality and characterstics of COVID-19 patients in Italy, JAMA March 23
Treatment of COVID ARDS, Lancet March 20
COVID in pregnant women (update), Lancet March 17
Upper respiratory viral load, NEJM March 18
Aerosol and surface stability of SARS-CoV-2 versus SARS-CoV, NEJM March 18
Lopinavir-Ritonavir trial, NEJM March 18th
Initial USA data, Feb 12- March 16, MMWR March 18
Transmission amongst crew members on cruise ship, MMWR March 17
Lidocaine during intubaiton and extubation of COVID-16, Can J Anaesth, March 16
Case report of fulminant myocarditis treated with steroids & IVIG, Euro H J, March 16
Coronavirus in pregnancy, Obstet Gynecol March 16th

COCHRANE COLLECTION: COVID-19 and Critical Care

             

Therapeutics

Although there is no data on drug treatment for COVID-19, there are trials underway and rational suggestions from clinicians involved in the care of these patients. These are summarized in the links below.

Clinical practice guidelines for COVID management (Greater Toronto Area), March 30


UK Recovery trial on hydroxychloroquine, online results June 5
Remdesivir: pharmacology review, Am Col Clin Pharm, June 2
Managing drug shortages during COVID, CJ Anesth, May 27
Remdesivir treatment RCT, NEJM, May 22
RCT of interferon, Kaletra, ribavirin in COVID, Lancet, May 8
Evidence-based treatment guidelines, CMAJ, April 29
Remdesevir RCT from China, Lancet April 29
COVID therapeutic research updates
Review of pharmacologic treatment of COVID-19, JAMA, April 13
Risks of COVID Treatment in pregnancy
Study of compassionate use of remdesivir, NEJM April 10
Siltuximab (anti-IL-6) study (Preprint), April 3
Treatment with convalencent plasma - 5 patient, JAMA, March 27
Lopinovir-Ritonovir RCT, NEJM, March 18
Open label trial of hydroxychloroquine + azithromycin (PREPRINT), March 18
Retrospective review of tocilizumab in COVID-19 in China (NOT PEER-REVIEWED),
COVID-19: combining antiviral and anti-inflammatory treatments, Lancet Feb27, 2020
NIH clinical trial of remdesivir to treat COVID-19 begins
Hopkins ABX Guide and COVID-19
Coronavirus puts drug repurposing on the fast track
COVID drug interactions

Steroids?
Pro -
Risk factors associated with ARDS & mortality, JAMA March 13th
Con - Severe SARS-CoV-2 and Intensive Care, ICM  Feb 26th

Research studies
Recombinant Human Angiotensin-converting Enzyme 2 (rhACE2) as a Treatment for Patients With COVID-19
Study to Evaluate the Safety and Antiviral Activity of Remdesivir (GS-5734™) in Participants With Severe COVID-19
The Efficacy and Safety of Thalidomide in the Adjuvant Treatment of Moderate New Coronavirus (COVID-19) Pneumonia
The Clinical Study of Carrimycin v lopinavir/ritonaviron or chloroquine on Treatment Patients With COVID-19
The Efficacy of Intravenous Immunoglobulin Therapy for Severe 2019-nCoV Infected Pneumonia
RCT of tocilizumab for treatment of COVID-19 (China)

Images, Infographics, lists, videos, guidelines

Position statement of infectivity, Singapore NCID, May 23
Thrombosis UK webinar: Management of thrombosis in COVID-19, May 19th
Unique attenuating mutation in COVID
Twitter thread on transmission dynamics, May 4
NHS (England) COVID Guidelines
Protected intubation video (Sinai, Toronto)
ESICM ventilation webinar (April 2):
 
-
Blog discussion
- Playback webinar
- Infographic
- Guy's & St. Thomas Vent algorithm
Mayo Clinic Knowledge Translation for COVID-19
Stanford OB Anesthesia intubation & extubation video
ISTH Thrombosis in COVID - Webinar
Hematological managament of COVID (from Guy's & St. Thomas Hospital)
COVID stages and immune response
Contained extubation in a Heliox-filled bag
Using Anesthetic Gas Machines for ICU ventilation
Calculating Recruitment/Inflation ratio & Airway Opening pressure (videos and calculator)
Using Anesthetic Gas Machines for ICU ventilation
Calculating Recruitment/Inflation ratio & Airway Opening pressure (videos and calculator)
"Critical Care for non-ICU Physicians" - free online by SCCM
Intensive Care Medicine: COVID simulation guidance, March 18th
COVID-19 "One Pager" by Seattle intensivist, Nick Mark
Coping with COVID-19 stress: 3 steps, By Jon Hunter & Bob Maunder
Interview by JAMA with Dr. Maurizio Cecconi from Lombardy, Italy - March 13th
Advice from OAA - COVI-19 in pregnancy

Algorithm for pregnant women with COVID-19

Pandemic Planning literature


Preparing intensive care for the next pandemic influenza, Crit Care 2019

Preparing the ICU for disaster, Crit Care Clinics 2019

Augmenting critical care capacity in a disaster, Crit Care Clin 2019

Triage, Crit Care Clinics, 2019

Disaster Care Considerations in Chronically Ill, Pregnant, and Morbidly Obese Patients, Crit Care Clin 2019


Chest consensus statement 2014

Critical Care during a Pandemic - Ontario OHPIP, 2006




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