Malin, Jakob J. ORCID: 0000-0002-2989-0436, Spinner, Christoph D., Janssens, Uwe, Welte, Tobias, Weber-Carstens, Steffen ORCID: 0000-0001-7405-0172, Schaelte, Gereon, Gastmeier, Petra, Langer, Florian, Wepler, Martin ORCID: 0000-0003-2015-814X, Westhoff, Michael, Pfeifer, Michael, Rabe, Klaus F. ORCID: 0000-0002-7020-1401, Hoffmann, Florian, Bottiger, Bernd W., Weinmann-Menke, Julia, Kersten, Alexander, Berlit, Peter, Krawczyk, Marcin ORCID: 0000-0002-0113-0777, Nehls, Wiebke, Fichtner, Falk, Laudi, Sven, Stegemann, Miriam, Skoetz, Nicole, Nothacker, Monika ORCID: 0000-0003-4928-7391, Marx, Gernot, Karagiannidis, Christian and Kluge, Stefan (2022). Key summary of German national treatment guidance for hospitalized COVID-19 patients Key pharmacologic recommendations from a national German living guideline using an Evidence to Decision Framework (last updated 17.05.2021). Infection, 50 (1). S. 93 - 107. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Purpose This executive summary of a national living guideline aims to provide rapid evidence based recommendations on the role of drug interventions in the treatment of hospitalized patients with COVID-19. Methods The guideline makes use of a systematic assessment and decision process using an evidence to decision framework (GRADE) as recommended standard WHO (2021). Recommendations are consented by an interdisciplinary panel. Evidence analysis and interpretation is supported by the CEOsys project providing extensive literature searches and living (meta-) analyses. For this executive summary, selected key recommendations on drug therapy are presented including the quality of the evidence and rationale for the level of recommendation. Results The guideline contains 11 key recommendations for COVID-19 drug therapy, eight of which are based on systematic review and/or meta-analysis, while three recommendations represent consensus expert opinion. Based on current evidence, the panel makes strong recommendations for corticosteroids (WHO scale 5-9) and prophylactic anticoagulation (all hospitalized patients with COVID-19) as standard of care. Intensified anticoagulation may be considered for patients with additional risk factors for venous thromboembolisms (VTE) and a low bleeding risk. The IL-6 antagonist tocilizumab may be added in case of high supplemental oxygen requirement and progressive disease (WHO scale 5-6). Treatment with nMABs may be considered for selected inpatients with an early SARS-CoV-2 infection that are not hospitalized for COVID-19. Convalescent plasma, azithromycin, ivermectin or vitamin D-3 should not be used in COVID-19 routine care. Conclusion For COVID-19 drug therapy, there are several options that are sufficiently supported by evidence. The living guidance will be updated as new evidence emerges.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Malin, Jakob J.UNSPECIFIEDorcid.org/0000-0002-2989-0436UNSPECIFIED
Spinner, Christoph D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Janssens, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Welte, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber-Carstens, SteffenUNSPECIFIEDorcid.org/0000-0001-7405-0172UNSPECIFIED
Schaelte, GereonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gastmeier, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langer, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wepler, MartinUNSPECIFIEDorcid.org/0000-0003-2015-814XUNSPECIFIED
Westhoff, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfeifer, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rabe, Klaus F.UNSPECIFIEDorcid.org/0000-0002-7020-1401UNSPECIFIED
Hoffmann, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bottiger, Bernd W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weinmann-Menke, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kersten, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlit, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krawczyk, MarcinUNSPECIFIEDorcid.org/0000-0002-0113-0777UNSPECIFIED
Nehls, WiebkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fichtner, FalkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laudi, SvenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stegemann, MiriamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Skoetz, NicoleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nothacker, MonikaUNSPECIFIEDorcid.org/0000-0003-4928-7391UNSPECIFIED
Marx, GernotUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karagiannidis, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kluge, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-605705
DOI: 10.1007/s15010-021-01645-2
Journal or Publication Title: Infection
Volume: 50
Number: 1
Page Range: S. 93 - 107
Date: 2022
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1439-0973
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
VENOUS THROMBOEMBOLISM; PREVENTION; PLACEBO; IVERMECTIN; PNEUMONIA; EFFICACY; SAFETYMultiple languages
Infectious DiseasesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60570

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