Update in COVID-19 in the intensive care unit from the 2020 HELLENIC Athens International symposium - 09/12/20

Doi : 10.1016/j.accpm.2020.10.008

Jordi Rello ^a,^b,^c, Mirko Belliato ^d, Meletios-Athanasios Dimopoulos ^e, Evangelos J. Giamarellos-Bourboulis ^f, Vladimir Jaksic ^g, Ignacio Martin-Loeches ^b,^h,^i,^j, Iosif Mporas ^k, Paolo Pelosi ^l,^m, Garyphallia Poulakou ⁿ, Spyridon Pournaras ^o, Maximiliano Tamae-Kakazu ^p, Jean-François Timsit ^q,^r, Grant Waterer ^s, Sofia Tejada ^a,^b,^⁎ , George Dimopoulos ^t
^a Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d’Hebron Institute of Research (VHIR), Barcelona, Spain
^b Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
^c Clinical Research in the ICU, Anaesthesia Department, CHU Nimes, Université de Nimes-Montpellier, France
^d Anestesia e Rianimazione II Cardiopolmonare, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
^e Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
^f 4^th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece
^g 3M Health Care, 3M Company, St. Paul, MN, USA
^h Multidisciplinary Intensive Care Research Organization (MICRO), Department of Intensive Care Medicine, St. James’s University Hospital, Dublin, Ireland
ⁱ Trinity Centre for Health Sciences, Dublin, Ireland
^j Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
^k School of Physics Engineering and Computer Science, University of Hertfordshire, Hatfield, United Kingdom
^l Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
^m Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
ⁿ 3^rd Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Sotiria General Hospital of Athens, Greece
^o Laboratory of Clinical Microbioloy, ATTIKON University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
^p Division of Pulmonary, Critical Care and Sleep Medicine, Spectrum Health – Michigan State University, Grand Rapids, Michigan, USA
^q AP-HP, Bichat Hospital, Medical and Infectious Diseases ICU (MI2), F-75018 Paris, France
^r University of Paris, IAME, INSERM, F-75018 Paris, France
^s School of Medicine, University of Western Australia, Australia
^t Department of Critical Care Medicine, National and Kapodistrian University of Athens, Medical School, Greece

^⁎Corresponding author at: Vall d'Hebron Institut de Recerca, Ps Vall d'Hebron 119 AMI-14th floor, 08035 Barcelona, Spain.Vall d'Hebron Institut de RecercaPs Vall d'Hebron 119 AMI-14th floorBarcelona08035Spain

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Highlights

•	Severe COVID-19 presents as multiple organ dysfunction syndrome (SARS-CoV-2 MODS).
•	Less is more in ventilating critically ill patients with severe COVID-19 pneumonia.
•	European Medicines Agency released approval for administration of steroids.
•	Main therapeutic targets: anti-inflammatory; anticoagulation; protective ventilation.

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Abstract

The 2020 International Web Scientific Event in COVID-19 pandemic in critically ill patients aimed at updating the information and knowledge on the COVID-19 pandemic in the intensive care unit. Experts reviewed the latest literature relating to the COVID-19 pandemic in critically ill patients, such as epidemiology, pathophysiology, phenotypes of infection, COVID-19 as a systematic infection, molecular diagnosis, mechanical ventilation, thromboprophylaxis, COVID-19 associated co-infections, immunotherapy, plasma treatment, catheter-related bloodstream infections, artificial intelligence for COVID-19, and vaccination. Antiviral therapy and co-infections are out of the scope of this review. In this review, each of these issues is discussed with key messages regarding management and further research being presented after a brief review of available evidence.

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Keywords : COVID-19, SARS-CoV-2, Pneumonia, Acute respiratory failure, ARDS, Intensive care

Plan

The five phenotypes of infection

COVID-19 is a systematic infection

COVID-19 management

Molecular diagnosis

Oxygenation and mechanical ventilation

Thromboprophylaxis

Immunotherapy

Plasma treatment

COVID-19 patients with specific conditions

CRBIs in COVID-19 era

The vaccine

Artificial intelligence and COVID-19

Conclusion

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Vol 39 - N° 6

P. 723-730 - décembre 2020 Retour au numéro

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Update in COVID-19 in the intensive care unit from the 2020 HELLENIC Athens International symposium - 09/12/20

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