TY - JOUR
T1 - Brazilian guidelines for the pharmacological treatment of patients hospitalized with covid-19
AU - Falavigna, Maicon
AU - Stein, Cinara
AU - Gomes, José Luiz
AU - Pontes De Azevedo, Luciano Cesar
AU - Belli, Karlyse Claudino
AU - Colpani, Verônica
AU - Da Cunha, Clóvis Arns
AU - Dal-Pizzol, Felipe
AU - Souza Dias, Maria Beatriz
AU - Ferreira, Juliana Carvalho
AU - Da Rocha Freitas, Ana Paula
AU - Gräf, Débora Dalmas
AU - Guimarães, Hélio Penna
AU - Ajeje Lobo, Suzana Margareth
AU - Monteiro, José Tadeu
AU - Nunes, Michelle Silva
AU - De Oliveira, Maura Salaroli
AU - Lucas Prado, Clementina Corah
AU - Canuto Santos, Vania Cristina
AU - Da Silva, Rosemeri Maurici
AU - Sobreira, Marcone Lima
AU - Veiga, Viviane Cordeiro
AU - Vidal, Ávila Teixeira
AU - Xavier, Ricardo Machado
AU - Zavascki, Alexandre Prehn
AU - Machado, Flávia Ribeiro
AU - Ribeiro De Carvalho, Carlos Roberto
N1 - Publisher Copyright:
© 2022, Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 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: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir+ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.
AB - Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 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: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir+ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.
KW - Brazil
KW - Covid-19
KW - Covid-19/ Drug Therapy
KW - Health Planning Guidelines
KW - Sars-Cov-2
UR - http://www.scopus.com/inward/record.url?scp=85186851081&partnerID=8YFLogxK
U2 - 10.5935/0103-507X.20220001-en
DO - 10.5935/0103-507X.20220001-en
M3 - Journal article
AN - SCOPUS:85186851081
SN - 2965-2774
VL - 34
SP - 1
EP - 12
JO - Critical Care Science
JF - Critical Care Science
IS - 1
ER -