COVID-19

coronavirus is one of many viruses that cause diseases in mammals and birds. In humans, coronaviruses cause respiratory tract infections that are typically mild, such as the common cold, though rarer forms such as SARS, MERS and COVID-19 can be lethal.

A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.

Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.

At the end of 2019, a novel Coronavirus (2019-nCoV) was found to be responsible for a cluster of atypical cases of pneumonia in Wuhan, China. Since then, the virus has spread both inside and outside China, and the WHO has declared this a public health emergency.

With the outbreak now present in Europe, and likely to affect many more areas over the coming months, we at ESICM have decided to help ICU professionals around the world by providing information that may make a vital contribution in the battle to contain the infection, treat the patients and to protect the frontline workers.

Learning from experience can save lives and, for this purpose, we are using this webpage to share key online resources, including manuscripts and summaries of papers published in the ICM journal and other important medical journals, podcast interviews with experts and colleagues who will discuss management strategies in place for preparedness and their own experiences on the ground.

ESICM will continue to provide the most up to date and crucial information in order to play its part and to face this global challenge.

UNITE-COVID-19

Take part in the latest ESICM project: an observational, multicenter, international point prevalence study.
Learn more and register here.

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GUIDELINES

Summary by David Lynes
Anaesthesia & Intensive Care, ESICM Editorial & Publishing Committee

Infographic by Marta Velia Antonini
CCN/CCP, MS Ist ICU University Hospital of Parma, Italy

FREE EDUCATIONAL CONTENT


ESICM academy

Acute Respiratory Distress Syndrome (ARDS)
> Access ACE- Course
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Acute respiratory failure ECLS
> Access ACE- Course
> Download PDF

Mechanical Ventilation
> Access ACE- Course
> Download PDF

Disseminated Intravascular Coagulation
> Access ACE- Course
> Download PDF

External resources

COVID-19 Critical Care: Understanding and Application – Free Online Resources

Learn the principles and practice of critical care for patients during the COVID-19 pandemic whilst protecting yourself and your peers. The University of Edinburgh and the Royal College of Physicians of Edinburgh are offering this free education resource to frontline clinical staff which teaches daily practice for critical care patients with or without COVID-19, and how to apply ventilation and organ support principles to a critically ill COVID-19 patient.

Discover how to facilitate your own emotional and physical wellbeing in this high-stress, high-risk environment. You will be able to select the materials that are most relevant to your work.

The information in this resource will support those refreshing critical care knowledge and skills, newly qualified doctors, those who are upskilling, and those returning to acute clinical services during the COVID-19 pandemic.

WEBINARS

ESICM IN THE NEWS

News

‘Get ready’: Italian doctors warn Europe of coronavirus impact on hospitals
Independent March 07, 2020.

Editorial

Health Care Heroes of the COVID-19 Pandemic
JAMA. Published online April 20, 2020.

Interview

AMA COVID-19 update
Ama-assn.org April 20, 2020.

ARTICLES

Articles published online on Intensive Care Medicine website (Springer) – free online

Review

Critical care management of adults with community-acquired severe respiratory viral infection.
Yaseen M. Arabi, Robert Fowler, Frederick G. Hayden in Intensive Care Medicine (2020).

Editorial

How to face the novel coronavirus infection during the 2019–2020 epidemic: the experience of Sichuan Provincial People’s Hospital.
Lingai Pan, Li Wang, Xiaobo Huang in Intensive Care Medicine (2020).

What’s New in Intensive Care

Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists.
Bouadma, L., Lescure, F., Lucet, J. et al. in Intensive Care Med (2020).

What’s New in Intensive Care

Novel coronavirus infection during the 2019–2020 epidemic: preparing intensive care units—the experience in Sichuan Province, China.
Xuelian Liao, Bo Wang, Yan Kang in Intensive Care Medicine (2020)

Letter

Challenges and countermeasures for organ donation during the SARS-CoV-2 epidemic: the experience of Sichuan Provincial People’s Hospital.
Lingai Pan, Jie Zeng & Hongji Yang. in Intensive Care Med (2020).

Letter

Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China.
Qiurong Ruan, Kun Yang, Wenxia Wang, Lingyu Jiang & Jianxin Song in Intensive Care Med (2020).

Letter

The novel coronavirus (SARS-CoV-2) infections in China: prevention, control and challenges.
Sheng Zhang, Meng Yuan Diao, Liwei Duan, Zhaofen Lin & Dechang Chen in Intensive Care Medicine (2020)

What’s New in Intensive Care

Critical care crisis and some recommendations during the COVID-19 epidemic in China.
Jianfeng Xie, Zhaohui Tong, Xiangdong Guan, Bin Du, Haibo Qiu & Arthur S. Slutsky in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

Imaging changes in severe COVID-19 pneumonia.
Wei Zhang in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

Imaging changes of severe COVID-19 pneumonia in advanced stage.
Wei Zhang in Intensive Care Medicine (2020)

Letter

Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic.
Qian-Yi Peng, Xiao-Ting Wang, Li-Na Zhang in Intensive Care Medicine (2020)

Letter

How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital
Jie Zeng, Jianxin Huang & Lingai Pan in Intensive Care Med (2020).

Letter

Clinical Features and Short-term Outcomes of 18 Patients with Corona Virus Disease 2019 in Intensive Care Unit
Jianlei Cao, Xiaoyong Hu, Wenlin Cheng, Lei Yu, Wen-Jun Tu & Qiang Liu in Intensive Care Med (2020).

Understanding the Disease

Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target
Haibo Zhang, Josef M. Penninger, Yimin Li, Nanshan Zhong & Arthur S. Slutsky in Intensive Care Med (2020).

Letter

Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis
Xiu-wu Pan, Da Xu, Hao Zhang, Wang Zhou, Lin-hui Wang & Xin-gang Cui in Intensive Care Med (2020).

Guidelines

Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)
Waleed Alhazzani, Morten Hylander Møller, […]Andrew Rhodes in Intensive Care Med (2020).

Letter

Clinicolaboratory Study of 25 Fatal Cases of COVID-19 in Wuhan
Wen-Jun Tu, Jianlei Cao, Lei Yu, Xiaorong Hu & Qiang Liu in Intensive Care Med (2020).

Letter

Thrombotic events in SARS-Cov 2 patients: an urgent call for ultrasound screening. with this final publication link
Guido Tavazzi, Luca Civardi, Luca Caneva, Silvia Mongodi & Francesco Mojoli in Intensive Care Med (2020).

Letter

15-day mortality and associated risk factors for hospitalized patients with COVID-19 in Wuhan, China: an ambispective observational cohort study
Ke Wang, Zhiguo Zhang, Muqing Yu, Yu Tao & Min Xie in Intensive Care Med (2020).

Letter

Time to consider histologic pattern of lung injury to treat critically ill patients with COVID-19 infection
Marie-Christine Copin, Erika Parmentier, Thibault Duburcq, Julien Poissy, Daniel Mathieu & The Lille COVID-19 ICU and Anatomopathology Group in Intensive Care Med (2020).

Correspondence

Are subpleural consolidations indicators for segmental pulmonary embolism in COVID-19?
Viviane Zotzmann, Corinna N. Lang, Fabian Bamberg, Christoph Bode & Dawid L. Staudacher in Intensive Care Med (2020).

What’s New in Intensive Care

Facing COVID-19 in ICU: vascular dysfunction, thrombosis, and dysregulated inflammation
Daniel E. Leisman, Clifford S. Deutschman & Matthieu Legrand in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

“No dose” lung ultrasound correlation with “low dose” CT scan for early diagnosis of SARS-CoV-2 pneumonia
Gary Duclos, Alexandre Lopez, Marc Leone & Laurent Zieleskiewicz in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

IL-6 may be a good biomarker for earlier detection of COVID-19 progressionChangsong Wang, Dongsheng Fei, Xueting Li, Mingyan Zhao & Kaijiang Yu in Intensive Care Med (2020).

Conference Report and Expert Panel

Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper
Andres Alban, Stephen E. Chick, Dave A. Dongelmans, Alexander P. J. Vlaar, Danielle Sent & Study Group in Intensive Care Med (2020).

Letter

New device and technique to protect intubation operators against COVID-19
Chaojin Chen, Ning Shen, Xiaoyun Li, Qi Zhang & Ziqing Hei in Intensive Care Med (2020).

Understanding the Disease

Understanding pathophysiology of hemostasis disorders in critically ill patients with COVID-19
Bérangère S. Joly, Virginie Siguret & Agnès Veyradier in Intensive Care Med (2020).

Letter

Clinical features and development of sepsis in patients infected with SARS-CoV-2: a retrospective analysis of 150 cases outside Wuhan, China
Di Ren, Chao Ren, Ren-qi Yao, Yong-wen Feng & Yong-ming Yao in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

SARS-CoV-2 pulmonary infection revealed by subcutaneous emphysema and pneumomediastinum
Maxime Lacroix, Farouk Graiess, Laurence Monnier-Cholley & Lionel Arrivé in Intensive Care Med (2020).

Understanding the Disease

Simplified immune-dysregulation index: a novel marker predicts 28-day mortality of intensive care patients with COVID-19
Hui Chen, Jun Wang, Nan Su, Xiebing Bao, Yongsheng Li & Jun Jin in Intensive Care Med (2020).

Correspondence

Incidence of pulmonary embolism in patients with COVID-19
Tatiana Helena Rech, Adriana Muradás Girardi & Marcelo Basso Gazzana in Intensive Care Med (2020).

Correspondence

Stages or phenotypes? A critical look at COVID-19 pathophysiology
Amit Jain & D. John Doyle in Intensive Care Med (2020).

Imaging in Intensive Care Medicine

Systemic arterial thrombosis and acute mesenteric ischemia in a patient with COVID-19 Eya Azouz, Sisi Yang, Laurence Monnier-Cholley & Lionel Arrivé in Intensive Care Med (2020).

Correspondence

Contrast-enhanced ultrasound (CEUS) of the lung reveals multiple areas of microthrombi in a COVID-19 patient
Alice Tee, Adrian Wong, Timothy Yusuff, Deepak Rao & Paul Sidhu in Intensive Care Med (2020).

Letter

Enhancing intensive care capacity: COVID-19 experience from a Tertiary Center in Israel
Eyal Leshem, Yoram Klein, Yael Haviv, Haim Berkenstadt & Itai M. Pessach in Intensive Care Med (2020).

Letter

Lung ultrasonography versus chest CT in COVID-19 pneumonia: a two-centered retrospective comparison study from China
Yong Yang, Yi Huang, Feng Gao, Lijun Yuan, Zhen Wang in Intensive Care Med (2020).

Letter

Admission chest CT score predicts 5-day outcome in patients with COVID-19
Elyas Mahdjoub Waqaas Mohammad Antoine Khalil in Intensive Care Med (2020).

Letter

Frailty index predicts poor outcome in COVID-19 patients
Giuseppe Bellelli, Paola Rebora, Maria Grazia Valsecchi… in Intensive Care Med (2020).

Letter

Spontaneous echo contrast in venous ultrasound of severe COVID-19 patients
Siddharth Dugar, Abhijit Duggal, Akbik Bassel, Mona Soliman in Intensive Care Med (2020).

Letter

Clinical phenotypes of critically ill COVID-19 patients
Elie Azoulay Lara Zafrani Sylvie Chevret in Intensive Care Med (2020).

Letter

Recognizing and supporting morally injured ICU professionals during the COVID-19 pandemic
Niek Kok Astrid Hoedemaekers Jelle van Gurp in Intensive Care Med (2020).

Correspondence

Coronavirus disease 2019 as a particular sepsis: a 2-week follow-up of standard immunological parameters in critically ill patients
Guillaume Monneret, Martin Cour, Sébastien Viel, Fabienne Venet & Laurent Argaud in Intensive Care Med (2020).

What’s New in Intensive Care

What’s new in lung ultrasound during the COVID-19 pandemic
Giovanni Volpicelli, Alessandro Lamorte, Tomás Villén in Intensive Care Med (2020).

What’s New in Intensive Care

Ten things we learned about COVID-19
Maurizio Cecconi Guido Forni Alberto Mantovani in Intensive Care Med (2020).

Correspondence

Rethinking the respiratory paradigm of COVID-19: a ‘hole’ in the argument
Rajkumar Rajendram, Ghulam Abbas Kharal, Naveed Mahmood, Rishi Puri & Mubashar Kharal in Intensive Care Med (2020).

Letter

Learning from mistakes during the pandemic: the Lombardy lesson
Alberto Zangrillo Luciano Gattinoni in Intensive Care Med (2020).

What’s New in Intensive Care

COVID-19: 10 things I wished I’d known some months ago
Peter Pickkers, Hans van der Hoeven, Giuseppe Citerio in Intensive Care Med (2020).

Editorial

How likely are COVID-19 interventions to benefit the sickest patients?
Anders Perner Bharath Kumar Tirupakuzhi Vijayaraghavan Balasubramanian Venkatesh in Intensive Care Med (2020).

Letter

Severe COVID-19 is associated with deep and sustained multifaceted cellular immunosuppression
Robin Jeannet Thomas Daix Bruno François in Intensive Care Med (2020).

Letter

Severity of endothelial dysfunction is associated with the occurrence of hemorrhagic complications in COPD patients treated by extracorporeal CO2 removal
Jean-Luc Diehl Jean Loup Augy David M. Smadja in Intensive Care Med (2020).

Letter

Hydroxychloroquine pharmacokinetic in COVID-19 critically ill patients: an observational cohort study
Benoit Painvin, Pauline Guillot, Marie-Clémence Verdier… in Intensive Care Med (2020).

Narrative Review

Inhalational volatile-based sedation for COVID-19 pneumonia and ARDS
Angela Jerath, Niall D. Ferguson & Brian H. Cuthbertson in Intensive Care Med (2020).

Less is More in Intensive Care

ICU beds: less is more? Not sure
Jason Phua, Madiha Hashmi & Rashan Haniffa in Intensive Care Med (2020).

Letter

SARS-CoV-2 viral loads and serum IgA/IgG immune responses in critically ill COVID-19 patients
Slim Fourati, Sophie Hue, Jean-Michel Pawlotsky, Armand Mekontso-Dessap & Nicolas de Prost in Intensive Care Med (2020).

Letter

Between-centre differences for COVID-19 ICU mortality from early data in England
Zhaozhi Qian, Ahmed M. Alaa, Mihaela van der Schaar & Ari Ercole in Intensive Care Med (2020).

From the Inside

Doctor–patient relationship at the time of COVID-19: travel notes
Fabrizio Vallelonga & Fabrizio Elia in Intensive Care Med (2020).

Correspondence

Rethinking the post-COVID-19 pandemic hospital: more ICU beds or smart monitoring on the wards?
Frederic Michard, Bernd Saugel & Benoit Vallet in Intensive Care Med (2020).

Understanding the Disease

Pulmonary immune responses against SARS-CoV-2 infection: harmful or not?
A. Guillon, P. S. Hiemstra & M. Si-Tahar in Intensive Care Med (2020).

From the Inside

Travelling to hell and back
Massimiliano Polastri in Intensive Care Med (2020).

Letter

Prediction of outcome of nasal high flow use during COVID-19-related acute hypoxemic respiratory failure
Noémie Zucman, Jimmy Mullaert, Damien Roux, Oriol Roca, Jean-Damien Ricard & Contributors in Intensive Care Med (2020).

Understanding the Disease

Pulmonary immune responses against SARS-CoV-2 infection: harmful or not?
A. Guillon, P. S. Hiemstra & M. Si-Tahar in Intensive Care Med (2020).

Letter

Efficacy of early prone position for COVID-19 patients with severe hypoxia: a single-center prospective cohort study
Xuefeng Zang, Qian Wang, Hua Zhou, Sanhong Liu, Xinying Xue COVID-19 Early Prone Position Study Group in Intensive Care Med (2020).

Articles accepted in Intensive Care Medicine (un-edited)

Moral Distress In The Intensive Care Unit During The Pandemic: The Burden Of Dying Alone
Constantinos Kanaris
> Read the Article

Physiological dead space ventilation, disease severity and outcome in ventilated patients with hypoxaemic respiratory failure due to Coronavirus Disease 2019
Francesco Vasques, Barnaby Sanderson, Federico Formenti, Manu Shankar-Hari, Luigi
Camporota
> Read the Article

Monitoring Of High-Flow Nasal Cannula For SARS-Cov-2 Severe Pneumonia: Less Is More, Better Look At Respiratory Rate
Damien Blez, Anne Soulier, Francis Bonnet, Etienne Gayat and Marc Garnier
> Read the Article

Increased Mortality in Patients with Severe SARS-CoV-2 Infection Admitted Within Seven Days of Disease Onset
Elie Azoulay, Muriel Fartoukh, Michael Darmon, Guillaume Géri, Guillaume Voiriot, Thibault Dupont, Lara Zafrani, Lola Girondas, Vincent Labbé, Martin Dres, Alexandra Beurton, Antoine Vieillard Baron, Alexandre Demoule
> Read the Article

The Prevalence, Risk Factors and Outcome of Cardiac Dysfunction in Hospitalized Patients with COVID19
Yuman Li, He Li, Meng Li, Li Zhang and Mingxing Xie
> Read the Article

The role of frailty in COVID-19 patients
Giuseppe Bellelli, Paola Rebora, Giuseppe Citerio
> Read the Article

Apoptosis and pericyte loss in alveolar capillaries in COVID-19 infection: choice of markers matters
Amit Jain, D. John Doyle
> Read the Article

RESEARCH

PPE SAFE
Personal Protective Equipment and healthcare worker Safety in the COVID-19 Era (The PPE-SAFE survey).

The survey is designed to understand your current situation. The survey is anonymous, it takes less than 10 minutes and can be completed from a cell phone or computer.

This survey is endorsed by ESICM – the European Society of Intensive Care Medicine and ESCMID ESGCIP and the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI).

This survey is aimed at ICU Health Care Workers directly involved in the clinical management of COVID-19 patients.

SARS-CoV-2 Pandemic Survey on Management of Resources & Patients

ESICM has endorsed an important survey, which aims to compile data about the management of COVID-19 patients and resources during the SARS-CoV-2 pandemic.

This survey was circulated by the Society to its international intensive care community of physicians, nurses and other allied health professionals for completion.

Please assist this essential research by providing your input. The survey will take approximately 15 minutes to complete.

UNITE – COVID-19 Study

COVID-19 is expected to be a challenge in ICUs globally until a safe and effective vaccine is found. Efforts to study the disease are paramount in order to advance our understanding of the disease, as well as improve treatment options. Although many registries are currently including patients, few of them focus on ICU patients, their specific treatments and newly-observed complications and challenges.

This one-day multi-centre, international anonymised point prevalence study is designed to discover more about the burden of COVID-19 in ICUs around the world, including regional differences, the current management of critically ill patients with COVID-19, variability in treatment and clinical characteristics and outcomes.

This study is endorsed by the European Society of Intensive Care Medicine.

FURTHER READING

Links to external resources & websites

Highlighted research articles and additional commentary from Springer journals.

JAMA Network COVID-19 Collection including Q&A.

Recommended articles and evidence from the Cochrane Library Special Collection.

Content from the Blog written by Tommaso Scquizzato & Giovanni Landoni of the Department of Anaesthesia & Intensive Care, IRCCS San Raffaele Scientific Institute, Milan (Italy).

ECDC information

The response of Milan’s Emergency Medical System to the COVID-19 outbreak in Italy – The Lancet

Elsevier’s Novel Coronavirus Information Center

Critical Care Clinics Issue focused on disaster medicine including pandemics