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Article ; Online: Moderately Low Effectiveness of the Influenza Quadrivalent Vaccine

Maaweya E. Awadalla / Haitham Alkadi / Modhi Alarjani / Abdullah E. Al-Anazi / Mohanad A. Ibrahim / Thamer Ahmad ALOhali / Mushira Enani / Wael Alturaiki / Bandar Alosaimi

Vaccines, Vol 11, Iss 1050, p

Potential Mismatch between Circulating Strains and Vaccine Strains

2023 Volume 1050

Abstract: The annual seasonal influenza vaccination is the most effective way of preventing influenza illness and hospitalization. However, the effectiveness of influenza vaccines has always been controversial. Therefore, we investigated the ability of the ... ...

Abstract	The annual seasonal influenza vaccination is the most effective way of preventing influenza illness and hospitalization. However, the effectiveness of influenza vaccines has always been controversial. Therefore, we investigated the ability of the quadrivalent influenza vaccine to induce effective protection. Here we report strain-specific influenza vaccine effectiveness (VE) against laboratory-confirmed influenza cases during the 2019/2020 season, characterized by the co-circulation of four different influenza strains. During 2019–2020, 778 influenza-like illness (ILI) samples were collected from 302 (39%) vaccinated ILI patients and 476 (61%) unvaccinated ILI patients in Riyadh, Saudi Arabia. VE was found to be 28% and 22% for influenza A and B, respectively. VE for preventing A(H3N2) and A(H1N1)pdm09 illness was 37.4% (95% CI: 43.7–54.3) and 39.2% (95% CI: 21.1–28.9), respectively. The VE for preventing influenza B Victoria lineage illness was 71.7% (95% CI: −0.9–3), while the VE for the Yamagata lineage could not be estimated due to the limited number of positive cases. The overall vaccine effectiveness was moderately low at 39.7%. Phylogenetic analysis revealed that most of the Flu A genotypes in our dataset clustered together, indicating their close genetic relatedness. In the post-COVID-19 pandemic, flu B-positive cases have reached three-quarters of the total number of influenza-positive cases, indicating a nationwide flu B surge. The reasons for this phenomenon, if related to the quadrivalent flu VE, need to be explored. Annual monitoring and genetic characterization of circulating influenza viruses are important to support Influenza surveillance systems and to improve influenza vaccine effectiveness.
Keywords	influenza viruses ; influenza A genotypes ; vaccines ; quadrivalent ; effectiveness ; phylogenetic analysis ; Medicine ; R
Subject code	630
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dual catastrophe of COVID-19

Mohammed AlSheef / Abdul Rehman Z. Zaidi / Majid Abonab / Mona Obaid / Khalid Bawazir / Syed Ziauddin A. Zaidi / Ghaydaa J. Kullab / Sultan Alawfi / Mushira Enani

Journal of Infection and Public Health, Vol 14, Iss 5, Pp 647-

Massive pulmonary embolism and stroke in a previously healthy young patient: A case report

2021 Volume 650

Abstract: We are reporting a 45-year-old woman with COVID-19 who presented to the Emergency Department with a transient loss of consciousness and was found to have a massive pulmonary embolism and an acute stroke. To our knowledge, this is the first reported case ... ...

Abstract	We are reporting a 45-year-old woman with COVID-19 who presented to the Emergency Department with a transient loss of consciousness and was found to have a massive pulmonary embolism and an acute stroke. To our knowledge, this is the first reported case that calls for attention to the importance of vigilance for such a catastrophic presentation of COVID-19.
Keywords	Coronavirus ; Coronavirus infections ; Beta coronavirus ; Venous thromboembolism ; Stroke ; Pulmonary embolism ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Promoting cross-regional collaboration in antimicrobial stewardship

Jameela Al Salman / Laila Al Dabal / Matteo Bassetti / Wadha A. Alfouzan / Muna Al Maslamani / Basem Alraddadi / Ashraf Elhoufi / Faryal Khamis / Eiman Mokkadas / Ingy Romany / Mushira Enani / Ali. Somily / Souha S. Kanj

Journal of Infection and Public Health, Vol 14, Iss 7, Pp 978-

Findings of an infectious diseases working group survey in Arab countries of the Middle East

2021 Volume 984

Abstract: Background: Antimicrobial resistance is a significant global issue that presents an increasing threat to patients’ wellbeing. Although a global concern, the emergence of multi-drug resistant organisms is of particular significance in the Middle East. In ... ...

Abstract	Background: Antimicrobial resistance is a significant global issue that presents an increasing threat to patients’ wellbeing. Although a global concern, the emergence of multi-drug resistant organisms is of particular significance in the Middle East. In recent years, this region has seen an alarming increase in antimicrobial resistance presenting a major challenge to physicians managing various infectious diseases. Methods: A Working Group comprising experts in infectious diseases from Arab countries of Middle East assembled to review similarities and differences in antimicrobial practices and management of multi-drug resistant organisms across the region and assess the barriers to achieving cross-regional collaboration. The Working Group conducted an anonymous online survey to evaluate current practice and understanding of management of multi-drug resistant organisms across the region. Results: A total of 122 physicians from Arab countries of the Middle East responded to the survey. Their responses demonstrated heterogeneity between countries in awareness of local epidemiology, management of multi-drug resistant organisms and antimicrobial stewardship practices. The Working Group recognized similarities and differences in the management of multi-drug resistant organisms across the region, and these were validated by the data collected in the survey. Overall, the similarities across the region reflect several key issues that can have an impact on the management of multi-drug resistant organisms and the prevention of antimicrobial resistance. Conclusions: This paper highlights the urgency of addressing antimicrobial resistance in Arab countries of the Middle East. The Working Group identified key barriers to effective management which may guide the development of future coherent strategies to promote effective antimicrobial stewardship in the region. Here, we outline a call to action for the region, with a need to focus on training and education, capacity building, infrastructure, regional research, and regional ...
Keywords	Multi-drug resistant organisms ; Antimicrobial stewardship ; Middle East ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Burden of non-tuberculous mycobacterial diseases in Saudi Arabian children

Bright Varghese / Mushira Enani / Mohammed Shoukri / Sameera AlJohani / Sahar AlThawadi / Sahal Al-Hajoj

Journal of Infection and Public Health, Vol 12, Iss 6, Pp 803-

The first nationwide experience

2019 Volume 808

Abstract: Background: Non-tuberculous mycobacteria (NTM) causing pulmonary and extra-pulmonary diseases are increasing worldwide. A large paucity of data related to pediatric NTM diseases exists globally and particularly in Saudi Arabia. Methods: The first ... ...

Abstract	Background: Non-tuberculous mycobacteria (NTM) causing pulmonary and extra-pulmonary diseases are increasing worldwide. A large paucity of data related to pediatric NTM diseases exists globally and particularly in Saudi Arabia. Methods: The first nationwide exploratory study on existence of NTM diseases among Saudi Arabian children (0–14 years old) has been carried out during 2016−2017. Suspected NTM isolates with clinical and demographical data were enrolled from regional reference laboratories. Species level identification of isolates was carried out by commercial line probe assays and gene sequencing. Results: In 12 months, 52 culture positive cases with 44(84.6%) confirmed disease incidences were identified. Demographically, Saudi nationals (86.5%) were dominated and 77.3% cases have different comorbid conditions. Lymphadenitis (40.4%) followed by 26.9% of pulmonary cases with 42.8% of confirmed clinical relevance were mainly reported. Species identification showed Mycobacterium simiae (31.8%), M. abscessus (23.1%) and nine other species including rarely encountering M. riyadhense. Ascites caused by M. monacense, pulmonary disease caused by M. riyadhense and M. monacense were rarest clinical events and reported for the first time globally in a pediatric cohort. Conclusions: Diverse NTM diseases even in immunocompetent children are an upcoming challenge in Saudi Arabia. Lack of awareness on NTM disease must be addressed with immediate development of management plans. Keywords: Pediatric non tuberculous mycobacterial disease, Saudi Arabia, NTM epidemiology, Mycobacterium simiae, M. riyadhense, M. abscessus, M. kubicae, M. monacense
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2019-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Point prevalence survey of antibiotic use in 26 Saudi hospitals in 2016

Maher Al Matar / Mushira Enani / Ghada Binsaleh / Hala Roushdy / Deema Alokaili / Amira Al Bannai / Yasser Khidir / Hail Al-Abdely

Journal of Infection and Public Health, Vol 12, Iss 1, Pp 77-

2019 Volume 82

Abstract: Objective: To evaluate the antibiotic prescribing trends, qualitatively and quantitatively, among Saudi Ministry of Health (MOH) hospitals. Method and materials: In May 2016, information about the hospitals and patients was collected for all inpatients ... ...

Abstract	Objective: To evaluate the antibiotic prescribing trends, qualitatively and quantitatively, among Saudi Ministry of Health (MOH) hospitals. Method and materials: In May 2016, information about the hospitals and patients was collected for all inpatients from 26 MOH hospitals in Saudi Arabia. Additional information about antibiotic treatment and infections was gathered. Data collection was done using Global Point Prevalence Survey (PPS) tool designed by University of Antwerp, Belgium. Results: A total of 3240 antibiotic doses were administrated to 2182 patients who represented 46.9% of the total eligible admitted patients. Of those patients on antibiotics, 510 (24%) patients were in the Intensive Care Unit (ICU), 646 (30.4%) patients were medically treated, and 972 (45.7%) patients were in surgical departments. The most commonly prescribed antibiotic group was third-generation cephalosporin (17.2%) and the most frequent indication was respiratory ract infectiont (n = 597; 18.2%). Antibiotics for surgical prophylaxis represented 23.4% of the total antibiotic doses. Of those, 78% were administrated for more than 24 hs. The rate of adherence to antibiotic guidelines was 48.1%. The indications for antibiotics were not documented in the patients’ notes for 51.1% of the prescriptions. Conclusion: This national PPS provided a useful tool to identify targets for quality improvement in order to enhance the prudent use of antibiotics in hospital settings. This survey can provide a background to assess the quality of antibiotic utilisation after any intervention by administering it regularly. Keywords: Antimicrobial stewardship, Antimicrobial consumption, Hospital, Point prevalence survey, Quality indicators
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC)

Pierre Tattevin / Gabriel Levy Hara / Adnene Toumi / Mushira Enani / Geoffrey Coombs / Andreas Voss / Heiman Wertheim / Armel Poda / Ziad Daoud / Ramanan Laxminarayan / Dilip Nathwani / Ian Gould

Frontiers in Medicine, Vol

2020 Volume 7

Abstract: Antimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income ...

Abstract	Antimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income countries (HIC), where overconsumption of antibiotics was associated with emergence of multidrug-resistant (MDR) bacteria. AMS in low- and middle-income countries (LMIC) is also necessary. However, programs effective in HIC may not perform as well in LMIC, because (i) While decreased consumption of antibiotics may be an appropriate target in overconsuming HIC, this may be dangerous in LMIC, where many patients die from the lack of access to antibiotics; (ii) although AMS programs in HIC can be designed and monitored through laboratory surveillance of resistance, surveillance programs are not available in many LMIC; (iii) the heterogeneity of health care systems implies that AMS programs must be carefully contextualized. Despite the need to individually tailor AMS programs in LMIC, international collaborations remain highly valuable, through the dissemination of high-quality documents and educational material, that may be shared, adapted where needed, and adopted worldwide. This process, facilitated by modern communication tools, combines many benefits, including: (i) saving time, a precious dimension for health care workers, by avoiding the duplication of similar works in different settings; (ii) taking advantage of colleagues skills, and initiatives, through open access to the work performed in other parts of the world; (iii) sharing experiences, so that we all learn from each others' successes and failures.
Keywords	antimicrobial stewardship ; low- and middle- income countries ; antibiotics ; resistance ; education ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Emergence of Rare Species of Nontuberculous Mycobacteria as Potential Pathogens in Saudi Arabian Clinical Setting.

Bright Varghese / Mushira Enani / Mohammed Shoukri / Sahar AlThawadi / Sameera AlJohani / Sahal Al-Hajoj

PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e

2017 Volume 0005288

Abstract: BACKGROUND:Clinical relevance of nontuberculous mycobacteria (NTM) is increasing worldwide including in Saudi Arabia. A high species diversity of NTM's has been noticed in a recent study. However, the identification in diagnostic laboratories is mostly ... ...

Abstract	BACKGROUND:Clinical relevance of nontuberculous mycobacteria (NTM) is increasing worldwide including in Saudi Arabia. A high species diversity of NTM's has been noticed in a recent study. However, the identification in diagnostic laboratories is mostly limited to common species. The impact of NTM species diversity on clinical outcome is so far neglected in most of the clinical settings. METHODOLOGY/PRINCIPAL FINDINGS:During April 2014 to September 2015, a nationwide collection of suspected NTM clinical isolates with clinical and demographical data were carried out. Primary identification was performed by commercial line probe assays. Isolates identified up to Mycobacterium species level by line probe assays only were included and subjected to sequencing of 16S rRNA, rpoB, hsp65 and 16S-23S ITS region genes. The sequence data were subjected to BLAST analysis in GenBank and Ez-Taxon databases. Male Saudi nationals were dominated in the study population and falling majorly into the 46-59 years age group. Pulmonary cases were 59.3% with a surprising clinical relevance of 75% based on American Thoracic Society guidelines. Among the 40.7% extra-pulmonary cases, 50% of them were skin infections. The identification revealed 16 species and all of them are reporting for the first time in Saudi Arabia. The major species obtained were Mycobacterium monascence (18.5%), M. cosmeticum (11.1%), M. kubicae (11.1%), M. duvalli (7.4%), M.terrae (7.4%) and M. triplex (7.4%). This is the first report on clinical relevance of M. kubicae, M. tusciae, M.yongonense, M. arupense and M.iranicum causing pulmonary disease and M. monascence, M. duvalli, M. perigrinum, M. insubricum, M. holsaticum and M. kyorinense causing various extra-pulmonary diseases in Saudi Arabia. Ascites caused by M. monascence and cecum infection by M. holsaticum were the rarest incidents. CONCLUSIONS/SIGNIFICANCE:To the first time in the country, clinical significance of various rare NTM's are well explored and the finding warrants a new threat to the Saudi Arabian ...
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	610 ; 590
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Demographic risk factors for extra-pulmonary tuberculosis among adolescents and adults in Saudi Arabia.

Hawra Al-Ghafli / Bright Varghese / Mushira Enani / Abdulrahman Alrajhi / Sameera Al Johani / Ali Albarrak / Sahar Althawadi / Noura Elkizzi / Sahal Al Hajoj

PLoS ONE, Vol 14, Iss 3, p e

2019 Volume 0213846

Abstract: Despite low infectious potential of extrapulmonary tuberculosis (EPTB), it poses significant clinical challenges in terms of diagnosis and treatment monitoring. Understanding the main demographical risk factors for disease characteristics of EPTB plays a ...

Abstract	Despite low infectious potential of extrapulmonary tuberculosis (EPTB), it poses significant clinical challenges in terms of diagnosis and treatment monitoring. Understanding the main demographical risk factors for disease characteristics of EPTB plays a crucial role in speeding up diagnosis process and improving overall clinical experience. The aim of this study was to investigate the main demographical and clinical risk factors for EPTB among adults and adolescents for the first time in Saudi Arabia. A cross-sectional multicenter study was carried out on a collection of 902 extrapulmonary Mycobacterium tuberculosis complex (MTBC) isolates with demographical and clinical data. All isolates were subjected to spoligotyping and 24-loci based MIRU-VNTR typing. The association between two potential variables was assessed using odd ratios (OR) calculations. Independent risk factors for EPTB and diseases characteristics of EPTB were identified using multivariate regression model analyses. Gender was found to be significantly associated with lymph node, gastrointestinal, central nervous system and urogenital TB. Lymph node TB showed statistical association to age group below 25 years, non-Saudis and South East Asian ethnicity. While gastrointestinal TB demonstrated an association with patients above 60 years old, and Saudis. Multivariate analysis showed that gender is an independent risk factor to urogenital TB (p 0.03) and lymph node TB (p 0.005). On the other hands, South Asian (p 0.01) and South East Asian (p 0.03) ethnicities were both identified as independent risk factors significantly associated with EPTB. MTBC lineages, site of infections, gender, HIV and smear positivity showed no significant association. Nationwide qualitative-studies are highly warranted in the future to further understand the main demographic risk factors for disease characteristics of EPTB.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Severity of COVID-19 infection in ACEI/ARB users in specialty hospitals

Ahmed A. Alrashed / Tahir M. Khan / Noara K. Alhusseini / Syed Mohammed Basheeruddin Asdaq / Mushira Enani / Bandar Alosaimi / Nada M. Alkhani / Yahya Mohzari / Maram M. Alghalbi / Wafa Alfahad / Mona A. Alanazi / Asma S. Albujaidya / Amal Ben-Akresh / Malak Almutairi / Ivo Abraham / Ahmad Alamer

Journal of Infection and Public Health, Vol 14, Iss 6, Pp 726-

A retrospective cohort study

2021 Volume 733

Abstract: Background: The uncertainty about COVID-19 outcomes in angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) users continues with contradictory findings. This study aimed to determine the effect of ACEI/ARB use in patients ... ...

Abstract	Background: The uncertainty about COVID-19 outcomes in angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) users continues with contradictory findings. This study aimed to determine the effect of ACEI/ARB use in patients with severe COVID-19. Methods: This retrospective cohort study was done in two Saudi public specialty hospitals designated as COVID-19 referral facilities. We included 354 patients with a confirmed diagnosis of COVID-19 between April and June 2020, of which 146 were ACEI/ARB users and 208 were non-ACEI/ARB users. Controlling for confounders, we conducted multivariate logistic regression and sensitivity analyses using propensity score matching (PSM) and Inverse propensity score weighting (IPSW) for high-risk patient subsets. Results: Compared to non-ACEI/ARB users, ACEI/ARB users had an eight-fold higher risk of developing critical or severe COVID-19 (OR = 8.25, 95%CI = 3.32–20.53); a nearly 7-fold higher risk of intensive care unit (ICU) admission (OR = 6.76, 95%CI = 2.88–15.89) and a nearly 5-fold higher risk of requiring noninvasive ventilation (OR = 4.77,95%CI = 2.15–10.55). Patients with diabetes, hypertension, and/or renal disease had a five-fold higher risk of severe COVID-19 disease (OR = 5.40,95%CI = 2.0−14.54]. These results were confirmed in the PSM and IPSW analyses. Conclusion: In general, but especially among patients with hypertension, diabetes, and/or renal disease, ACEI/ARB use is associated with a significantly higher risk of severe or critical COVID-19 disease, and ICU care.
Keywords	Angiotensin-converting enzyme inhibitor ; Angiotensin II receptor blocker ; COVID-19 ; Mortality ; Disease severity ; Hospital admission ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU

Waleed Alhazzani / Mohammed Alshahrani / Fayez Alshamsi / Ohoud Aljuhani / Khalid Eljaaly / Samaher Hashim / Rakan Alqahtani / Doaa Alsaleh / Zainab Al Duhailib / Haifa Algethamy / Tariq Al-Musawi / Thamir Alshammari / Abdullah Alqarni / Danya Khoujah / Wail Tashkandi / Talal Dahhan / Najla Almutairi / Haleema A. Alserehi / Maytha Al-Yahya /

Bandar Al-Judaibi / Yaseen M. Arabi / Jameel Abualenain / Jawaher M. Alotaibi / Ali Al bshabshe / Reham Alharbi / Fahad Al-Hameed / Alyaa Elhazmi / Reem S. Almaghrabi / Fatma Almaghlouth / Malak Abedalthagafi / Noor Al Khathlan / Faisal A. Al-Suwaidan / Reem F. Bunyan / Bandar Baw / Ghassan Alghamdi / Manal Al Hazmi / Yasser Mandourah / Abdullah Assiri / Mushira Enani / Maha Alawi / Reem Aljindan / Ahmed Aljabbary / Abdullah Alrbiaan / Fahd Algurashi / Abdulmohsen Alsaawi / Thamer H. Alenazi / Mohammed A. Alsultan / Saleh A. Alqahtani / Ziad Memish / Jaffar A. Al-Tawfiq

Journal of Infection and Public Health, Vol 15, Iss 1, Pp 142-

Therapy section

2022 Volume 151

Abstract: Background: The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based ... ...

Abstract	Background: The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). Methods: The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. Results: The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. Conclusion: The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available.
Keywords	COVID-19 ; Therapy ; Practice guideline ; Intensive care unit ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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