**4. Conclusions**

In anticipation of COVID-19 demands upon nursing staff and subsequent potential weakening of care levels in the provision of patient care, specifically in the ICU setting, a panel was formed to raise and answer critical concerns. The nursing surge capacity of critically ill patients with COVID-19 in the ICU was addressed through searching available evidence. Substantiation was retrieved from a variety of databases inclusive of published and unpublished studies. The retrieved studies were then reviewed by a minimum of two reviewers independently using JBI critical appraisal tools. The recommendations in the recent guidelines covered ICU nursing surge capacity strategies. We recommend that hospitals implement the evidence-based strategies that have been shown to be effective such as a team-based approach, and to establish other innovative strategies for ICU nursing staff surge capacity in the COVID-19 pandemic. As new evidence presents itself, further updates of the guideline will be issued.

**Author Contributions:** A.A.M.–Conception, manuscript preparation; A.A.–Conception; Z.A.–Manuscript preparation; K.A.S.–Manuscript preparation; D.S.–Manuscript preparation. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Acknowledgments:** Authors acknowledge Sulaiman Al Habib Research Center that supported this research.

**Conflicts of Interest:** The authors declare no conflict of interest.
