The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Falavigna Maicon, Araujo Cintia Laura Pereira de, Barbosa Alexandre Naime, Belli Karlyse Claudino, Colpani Verônica, Dal-Pizzol Felipe, Silva Rosemeri Maurici da, Azevedo Luciano César Pontes de, Dias Maria Beatriz Souza, Amaral José Luiz Gomes do, Dorneles Gilson Pires, Ferreira Juliana Carvalho, Freitas Ana Paula da Rocha, Gräf Débora Dalmas, Guimarães Hélio Penna, Lobo Suzana Margareth Ajeje, Machado Flávia Ribeiro, Nunes Michelle Silva, Oliveira Maura Salaroli de, Parahiba Suena Medeiros, Rosa Regis Goulart, Santos Vania Cristina Canuto, Sobreira Marcone Lima, Veiga Viviane Cordeiro, Xavier Ricardo Machado, Zavascki Alexandre Prehn, Stein Cinara, Carvalho Carlos Roberto Ribeiro de
Аннотация
METHODS: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method.
RESULTS: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made.
CONCLUSION: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.