Brazilian guidelines for the treatment of outpatients with suspected or confirmed COVID-19. A joint guideline of the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Medical Association (AMB), Brazilian Society of Angiology and Vascular Surgery (SBACV), Brazilian Society of Geriatrics and Gerontology (SBGG), Brazilian Society of Infectious Diseases (SBI), Brazilian Society of Family and Community Medicine (SBFMC), and Brazilian Thoracic Society (SBPT).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Falavigna Maicon, Belli Karlyse Claudino, Barbosa Alexandre Naime, Zavascki Alexandre Prehn, Nastri Ana Catharina de Seixas Santos, Santana Christiane Machado, Stein Cinara, Gräf Débora Dalmas, Cadegiani Flavio Adsuara, Guimarães Hélio Penna, Monteiro José Tadeu, Ferreira Juliana Carvalho, de Azevedo Luciano Cesar Pontes, Magri Marcelo Mihailenko Chaves, Sobreira Marcone Lima, Dias Maria Beatriz Gandra de Souza, de Oliveira Maura Salaroli, Corradi Mirian de Freitas Dal Ben, Rosa Regis, Heinzelmann Ricardo Souza, da Silva Rosemeri Maurici, Junior Rubens Belfort, Cimerman Sergio, Colpani Verônica, Veiga Viviane Cordeiro, de Carvalho Carlos Roberto Ribeiro
Аннотация
METHODS: A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines. A rapid guideline development method was used, based on the adoption and/or adaptation of recommendations from existing international guidelines combined with additional structured searches for primary studies and new recommendations whenever necessary (GRADE-ADOLOPMENT). The rating of quality of evidence and the drafting of recommendations followed the GRADE method.
RESULTS: Ten technologies were evaluated, and 10 recommendations were prepared. Recommendations were made against the use of anticoagulants, azithromycin, budesonide, colchicine, corticosteroids, hydroxychloroquine/chloroquine alone or combined with azithromycin, ivermectin, nitazoxanide, and convalescent plasma. It was not possible to make a recommendation regarding the use of monoclonal antibodies in outpatients, as their benefit is uncertain and their cost is high, with limitations of availability and implementation.
CONCLUSION: To date, few therapies have demonstrated effectiveness in the treatment of outpatients with COVID-19. Recommendations are restricted to what should not be used, in order to provide the best treatment according to the principles of evidence-based medicine and to promote resource savings by aboiding ineffective treatments.