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Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

Table S4. PICO question: Recommendation 4

In healthcare workers performing non-aerosol-generating procedures on mechanically ventilated patients with COVID-19, should we recommend using fitted respirator mask, versus surgical/medical masks?

Population	Intervention	Comparator	Outcomes
Healthcare workers	Fitted respirator	Medical/surgical	1. Disease
performing non-	mask	mask	transmission
aerosol-generating
procedures

Table S5. PICO question: Recommendation 5-6

In healthcare workers performing endotracheal intubation on patients with COVID-19, should we recommend using video guided laryngoscopy, over direct laryngoscopy?

Population	Intervention	Comparator	Outcomes
Healthcare workers	video guided	direct	1. Disease
performing	laryngoscopy	laryngoscopy	transmission
endotracheal
intubation

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

Infection Control Evidence Summaries:

Figure S4. Recommendation 3: N-95 vs surgical maskLab confirmed influenza infection

Figure S5. Recommendation 3: N-95 vs surgical maskLab resp infection

Figure S6. Recommendation 3: N-95 vs surgical mask- influenza-like illness

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

Table S6. Recommendation 3: Evidence Profile
Outcomes	№ of	Relative effect	Certainty of the
	participants	(95% CI)	evidence
	(studies)		(GRADE)
Lab-confirmed influenza	(4 RCTs)	OR 1.08	LOW
		(0.84 to 1.38)
Lab-confirmed resp	(4 RCTs)	OR 0.94	LOW
infections		(0.80 to 1.11)
Influenza like illness	(4 RCTs)	OR 0.76	LOW
		(0.51 to 1.13)
Clinical resp infections	(3 RCTs)	OR 0.67	VERY LOW
		(0.44 to 1.02)

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

Laboratory Diagnosis and Specimens Questions:

Table S7. PICO question: Recommendation 7.1

In mechanically ventilated patients with suspected COVID-19, should we recommend sending upper respiratory tract samples versus lower respiratory tract samples?

Population	Intervention	Comparator	Outcomes
Mechanically ventilated	Upper	Lower	1.	Diagnostic
adults with suspected	respiratory tract	respiratory tract		accuracy
COVID-19 infection	sample	sample	2.	Patient harm
			3.	Infection risk to
				healthcare
				workers

Table S8. PICO question: Recommendation 7.2

In mechanically ventilated patients with suspected COVID-19, should we recommend sending endotracheal aspirate samples versus bronchoscopic samples?

Population	Intervention	Comparator	Outcomes
Mechanically ventilated	Endotracheal	Bronschoscopic	1.	Diagnostic
adults with suspected	aspirate	sample		accuracy
COVID-19 infection			2.	Patient harm
			3.	Infection risk to
				healthcare
				workers

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

Hemodynamic support Questions:

Table S9. PICO question: Recommendation 8

In adults with COVID-19 and shock, should we assess fluid responsiveness by dynamic

or static measures?
Population	Intervention	Comparator	Outcomes
Adults with	Dynamic parameters	Static parameters	2.	Mortality
COVID-19 and			3.	Length of stay
shock				ICU
			4.	Duration of
				mechanical
				ventilation

Table S10. PICO question: Recommendation 9

In adults with COVID-19 and shock, should we use a conservative (fluid restrictive) or

liberal fluid strategy?
Population	Intervention	Comparator	Outcomes
Adults with COVID-	Conservative strategy	Liberal strategy	1.	Mortality
19 and shock			2.	Serious
				adverse events
			3.	Ventilator-free
				days
			4.	Length of stay
				ICU

Table S11. PICO question: Recommendation 10

In adults with COVID-19 and shock, should we use intravenous crystalloids or colloids

for fluid resuscitation?
Population	Intervention	Comparator	Outcomes

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES			Un-edited accepted proof*
Adults with	Intravenous	Intravenous	1.	Mortality
COVID-19 and	crystalloids	colloids	2.	Serious adverse
shock				events

Table S12. PICO question: Recommendation 11

In adults with COVID-19 and shock, should we use buffered/balanced crystalloids or unbalanced crystalloids for fluid resuscitation?

Population	Intervention	Comparator	Outcomes
Adults with	Balanced/buffered	Unbalanced	1.	Mortality
COVID-19 and	crystalloids	crystalloids	2.	Serious
shock				adverse events

Table S13. PICO question: Recommendation 12

In adults with COVID-19 and shock, should we use hydroxyethyl starches for fluid

resuscitation?
Population	Intervention	Comparator	Outcomes
Adults with COVID-	Hydroxyethyl starches	Crystalloids	1.	Mortality
19 and shock			2.	Renal
				replacement
				therapy
			3.	Blood
				transfusion

Table S14. PICO question: Recommendation 13

In adults with COVID-19 and shock, should we use gelatins for fluid resuscitation?

Population

Intervention

Comparator

Outcomes

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES		Un-edited accepted proof*
Adults with COVIDGelatins	Crystalloids	1. Mortality
19 and shock

Table S15. PICO question: Recommendation 14

In adults with COVID-19 and shock, should we use dextrans for fluid resuscitation?

Population	Intervention	Comparator	Outcomes
Adults with COVID-	Dextrans	Crystalloids	1.	Mortality
19 and shock			2.	Blood
				transfusion

Table S16. PICO question: Recommendation 15

In adults with COVID-19 and shock, should we use albumin for fluid resuscitation?

Population	Intervention	Comparator	Outcomes
Adults with COVID-	Albumin	Crystalloids	1.	Mortality
19 and shock			2.	Renal
				replacement
				therapy
			3.	Blood
				transfusion

Table S17. PICO question: Recommendation 16

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES			Un-edited accepted proof*
In adults with COVID-19 and shock, should we use norepinephrine or other vasoactive
agents as first-line treatment?
Population	Intervention	Comparator	Outcomes
Adults with	Norepinephrine	Other	1.	Mortality
COVID-19 and		vasoactive	2.	Serious
shock		agents		adverse events

Table S18. PICO question: Recommendation 17

In adults with COVID-19 and shock, should we use either vasopressin or epinephrine, if norepinephrine is not available?

Population	Intervention	Comparator	Outcomes
Adults with COVID-	Vasopressin	Epinephrine	1.	Mortality
19 and shock			2.	Serious
				adverse events

Table S19. PICO question: Recommendation 18

In adults with COVID-19 and shock, should we use dopamine or norepinephrine?

Population	Intervention	Comparator	Outcomes
Adults with COVID-	Dopamine	Norepinephrine	1.	Mortality
19 and shock			2.	Arrythmias

Table S20. PICO question: Recommendation 19

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

In adults with COVID-19 and shock, should we add vasopressin as a second-line agent or should we titrate norepinephrine, if mean arterial pressure (MAP) target cannot be achieved by norepinephrine?

Population	Intervention	Comparator	Outcomes
Adults with	Vasopressin	Norepinephrine	1.	Mortality
COVID-19 and			2.	Atrial
shock				fibrillation
			3.	Digital ischemia

Table S21. PICO question: Recommendation 20

In adults with COVID-19 and shock, should we titrate vasoactive agents to a MAP of 60-

65 mmHg or use higher MAP targets?

Population	Intervention	Comparator	Outcomes
Adults with	MAP 60-65 mmHg	MAP >65 mmHg	1.	Mortality
COVID-19 and			2.	Arrhythmias
shock			3.	Myocardial Injury
			4.	Limb ischemia

Table S22. PICO question: Recommendation 21

In adults with COVID-19 and shock with evidence of cardiac dysfunction and persistent hypoperfusion despite fluid resuscitation and norepinephrine, should we add dobutamine

or increase norepinephrine dose?
Population	Intervention	Comparator	Outcomes
COVID-19 and shock	Dobutamine	No dobutamine	1.	Mortality
with evidence of			2.	Serious adverse
cardiac dysfunction				events

and persistent hypoperfusion despite

Intensive Care Medicine

SSC COVID-19 GUIDELINES SUPPLEMENTARY FILES

Un-edited accepted proof*

fluid resuscitation and norepinephrine

Table S23. PICO question: Recommendation 22

In adults with COVID-19 and refractory shock, should we use low-dose corticosteroid

therapy or not?
Population	Intervention	Comparator	Outcomes
COVID-19 and	Low-dose corticosteroids	No low-dose	1.	Mortality
refractory shock		corticosteroids	2.	Serious
				adverse
				events

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