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Quality Assessment of 45 Guidelines on Management of Critical Care Patients with COVID-19: A Systematic Review and AGREE II Instrument Assessment

46 Pages Posted: 19 Oct 2020

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Abstract

Background: In response to the COVID-19 pandemic, a host of rapid guidelines (RGs) have been published to inform clinicians and decision-makers on best management for people with COVID-19. We assessed the quality of RGs for management of critically ill patients with COVID-19.

Methods: We performed a rapid systematic review of RGs for the critical care patients with COVID-19. Medline (OVID), CINAHL (EBSCO), EMBASE, CNKI, CBM, WanFang, and relevant databases and websites were systematically searched through 31 st July 2020. The AGREE II instrument was used to assess the quality of included RGs and summarize relevant therapeutic interventions.

Results: A total of 45 RGs for critically ill patients with COVID-19 were included. Ten were multinational and the remaining from individual countries. The clinical topics included in each RG varied: 41 were for general critical care unit management, two covered patients with tracheostomy, six covered children, four covered women, five covered cardiovascular diseases, 12 covered emergencies, 19 covered patients with pneumonia, and one was for patients receiving renal replacement therapy. Average scores for the six domains of the AGREE II instrument were 70%, 40%, 26%, 74%, 28%, 41% for the scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, editorial independence, respectively. Recommendations for therapeutic interventions were summarized.

Interpretation: Most of the RGs for critical care in response to COVID-19 included in the review showed a low overall quality (less than 40%). Future RGs for COVID-19 need to rely, for their development, on standard evidence-based methods and tools.

Funding Statement: This work was supported by the Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.

Declaration of Interests: None.

Keywords: COVID-19; Guidelines; Critical Care; Quality

Suggested Citation

Amer, Yasser Sami and Titi, Maher A. and Godah, Mohammad Wefqy and Wahabi, Hayfaa A. and Hneiny, Layal and Hamad, Muddathir H. and ElGohary, Ghada Metwally and Abouelkheir, Manal Mohamed and Hamouda, Mohamed Ben and Ouertatani, Hella and Velásquez Salazar, Pamela and Acosta-Reyes, Jorge and Alhabib, Samia M. and Esmaeil, Samia Ahmed and Fedorowicz, Zbys and Zhang, Ailing and Chen, Zhe and Liptrott, Sarah Jayne and Frungillo, Niccolò and Jamal, Amr A. and Almustanyir, Sami A. and Dieyi, Newman Ugochukwu and Powell, John and Hon, Katrina J. and Florez, Ivan, Quality Assessment of 45 Guidelines on Management of Critical Care Patients with COVID-19: A Systematic Review and AGREE II Instrument Assessment (9/2/2020). Available at SSRN: https://ssrn.com/abstract=3686844 or http://dx.doi.org/10.2139/ssrn.3686844

Yasser Sami Amer

Independent

Maher A. Titi

Independent

Mohammad Wefqy Godah

Independent

Hayfaa A. Wahabi

Independent

Layal Hneiny

Independent

Muddathir H. Hamad

Independent

Mohamed Ben Hamouda

Independent

Hella Ouertatani

Independent

Jorge Acosta-Reyes

Independent

Samia M. Alhabib

Independent

Samia Ahmed Esmaeil

Independent

Zbys Fedorowicz

Independent

Ailing Zhang

Independent

Zhe Chen

Independent

Sarah Jayne Liptrott

Independent

Niccolò Frungillo

Independent

Amr A. Jamal

Independent

Sami A. Almustanyir

Independent

John Powell

Independent

Katrina J. Hon

Independent

Ivan Florez (Contact Author)

McMaster University ( email )