Covid-19 Treatment Guidelines: Infectious Disease Society of America
Summary of
COVID-19 Treatment Guidelines
Infectious
Diseases Society of America (ISDA) Guidelines on the Treatment and
Management of Patients with COVID-19 in my words
Published by IDSA,
4/11/2020
The following is my take on the treatment recommendations put
out by the experts at the Infectious Diseases Society of America. The original article
can be accessed here.
Most people who become infected, suffer a mild illness
consisting of sore throat, cough and fever. In some cases, the virus infects the
lungs causing shortness of breath and pneumonia. For those who are advised
hospitalization, the treatments may include intravenous fluids and control of
the fever. In more severe cases, breathing support may be needed in the form of
a ventilator.
Since there is no established treatment for this novel virus,
many treatments are being tested. The treatments (clinical trials) are
available at most of the major hospitals and institutions. The experts at the ISDA have the following 7 treatment
recommendations:
Recommendation 1. Among patients who have been admitted to
the hospital with COVID-19, the IDSA guideline panel recommends
hydroxychloroquine/chloroquine (HCQ) in
the context of a clinical trial.
Recommendation 2. Among patients who have been admitted to
the hospital with COVID-19, the IDSA guideline panel recommends
hydroxychloroquine/chloroquine plus azithromycin only in the context of a
clinical trial.
Comments:
The currently available best evidence failed to demonstrate
or to exclude a beneficial effect of HCQ on clinical progression of COVID-19 or
on viral clearance by molecular (PCR) tests, although a somewhat higher
proportion in the HCQ group experienced clinical improvement. However, the
certainty in the evidence was rated as very low mainly due to small sample
sizes.
**********
Recommendation 3. Among patients who have been admitted to
the hospital with COVID-19, the IDSA guideline panel recommends the combination
of lopinavir/ritonavir only in the context of a clinical trial.
Comments:
The guideline panel recommends the use of lopinavir/ritonavir
only in the context of a clinical trial. Benefits and Toxicities are of the
same degree. Additional clinical trials or prospective outcome registries are
needed to inform research for treatment with lopinavir/ritonavir and other
HIV-1 protease inhibitors for patients with COVID-19
**********
Recommendation 4. Among patients who have been admitted to
the hospital with COVID-19 pneumonia, the IDSA guideline panel suggests against
the use of corticosteroids. (Conditional recommendation, very low certainty of
evidence)
Recommendation 5. Among patients who have been admitted to
the hospital with ARDS due to COVID-19, the IDSA guideline panel recommends the
use of corticosteroids in the context of a clinical trial.
Comments:
Steroids were widely used in China to prevent the development
of respiratory distress (ARDS) in patients with COVID-19 pneumonia. As
COVID-19 is a self-limited viral illness in most cases, a small subset of
patients progresses from COVID-19 pneumonia to develop ARDS. Based on limited
data from other coronaviruses, there is no clear benefit and potential harm
from corticosteroids.
*************
Recommendation 6. Among patients who have been admitted to
the hospital with COVID-19, the IDSA guideline panel recommends tocilizumab
only in the context of a clinical trial.
Comments:
It was estimated that the patients in one study (21 patients,
4 critical and 17 severe) would have had a baseline risk of death at 20% as
matched in severity. Therefore, treatment with tocilizumab may have reduced
mortality since there were no deaths reported out of 21 patients. However, this
conclusion remains highly uncertain given the lack of a contemporaneous control
or adjustments for confounding factors. Out of 21 patients, 19 were discharged
from the hospital suggesting a 9.5% rate of failure of clinical improvement in
the CT scan findings.
The guideline panel recommended tocilizumab only in the
context of a clinical trial.
*********
Recommendation 7. Among patients who have been admitted to
the hospital with COVID-19, the IDSA guideline panel recommends COVID-19
convalescent plasma in the context of a clinical trial.
Comments
Compared with a 30% mortality rate in the historical control
(3/10), no deaths were reported among patients receiving COVID-19 convalescent
plasma. The guideline panel recommends COVID-19 convalescent plasma in the context
of a clinical trial.
gioco digitale - stillcasino.com | VISA VISA VISA VISA WELCOME
ReplyDeletegioco digitale is online casino real money gioco digitale for US players, not happyluke only with Visa or Mastercard, but also with more than a dozen online casinos クイーンカジノ
The great article you have posted here. This is an effective method for expanding our insight. Keep sharing this sort of articles, Thank you.Drug treatment in Bakersfield, CA
ReplyDeleteThe depiction of this article is truly astounding. I think this is a genuinely supportive and edifying article for everyone, I esteem this kind of piece, Grateful to you for sharing an article like this.Mental health in Bakersfield, CA
ReplyDeleteYou have given uncommon substance here. I'm really glad to find this post as I found lots of huge data in your article. Appreciation for sharing an article like this.Behavioral health services in San Clarita, CA
ReplyDeleteThey additionally offer distinctive ways to play, including sportsbook pools and decide ’em contests. Let’s a glance at|check out} a few 1xbet korea of the the} greatest sports betting apps in Colorado, together with what every has to supply. In 2018, Europe held the very best share of 57.20% of the worldwide cellular playing market. Canada doesn’t have some strict laws phrases of|in relation to} playing. In truth, the country is sort of|a sort of} where players can freely gamble on-line at offshore websites due to of} a scarcity of official rules. Legal or not, playing stays a well-liked activity amongst Canadians.
ReplyDelete