Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Malin, Jakob J. UNSPECIFIED orcid.org/0000-0002-2989-0436 UNSPECIFIED Spinner, Christoph D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Janssens, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Welte, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber-Carstens, Steffen UNSPECIFIED orcid.org/0000-0001-7405-0172 UNSPECIFIED Schaelte, Gereon UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Langer, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wepler, Martin UNSPECIFIED orcid.org/0000-0003-2015-814X UNSPECIFIED Westhoff, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeifer, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Rabe, Klaus F. UNSPECIFIED orcid.org/0000-0002-7020-1401 UNSPECIFIED Hoffmann, Florian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bottiger, Bernd W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weinmann-Menke, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Kersten, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlit, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Krawczyk, Marcin UNSPECIFIED orcid.org/0000-0002-0113-0777 UNSPECIFIED Nehls, Wiebke UNSPECIFIED UNSPECIFIED UNSPECIFIED Fichtner, Falk UNSPECIFIED UNSPECIFIED UNSPECIFIED Laudi, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Stegemann, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Skoetz, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED Nothacker, Monika UNSPECIFIED orcid.org/0000-0003-4928-7391 UNSPECIFIED Marx, Gernot UNSPECIFIED UNSPECIFIED UNSPECIFIED Karagiannidis, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kluge, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language VENOUS THROMBOEMBOLISM; PREVENTION; PLACEBO; IVERMECTIN; PNEUMONIA; EFFICACY; SAFETY Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60570