Management of hospitalised adults with coronavirus disease 2019 (COVID-19): A European respiratory society living guideline
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Management of hospitalised adults with coronavirus disease 2019 (COVID-19) : A European respiratory society living guideline. / Chalmers, James D.; Crichton, Megan L.; Goeminne, Pieter C.; Cao, Bin; Humbert, Marc; Shteinberg, Michal; Antoniou, Katerina M.; Ulrik, Charlotte Suppli; Parks, Helen; Wang, Chen; Vandendriessche, Thomas; Qu, Jieming; Stolz, Daiana; Brightling, Christopher; Welte, Tobias; Aliberti, Stefano; Simonds, Anita K.; Tonia, Thomy; Roche, Nicolas.
I: The European Respiratory Journal, Bind 57, Nr. 4, 2100048, 2021.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Management of hospitalised adults with coronavirus disease 2019 (COVID-19)
T2 - A European respiratory society living guideline
AU - Chalmers, James D.
AU - Crichton, Megan L.
AU - Goeminne, Pieter C.
AU - Cao, Bin
AU - Humbert, Marc
AU - Shteinberg, Michal
AU - Antoniou, Katerina M.
AU - Ulrik, Charlotte Suppli
AU - Parks, Helen
AU - Wang, Chen
AU - Vandendriessche, Thomas
AU - Qu, Jieming
AU - Stolz, Daiana
AU - Brightling, Christopher
AU - Welte, Tobias
AU - Aliberti, Stefano
AU - Simonds, Anita K.
AU - Tonia, Thomy
AU - Roche, Nicolas
N1 - Publisher Copyright: © The authors 2021. This version is distributed under the terms of the Creative Commons Attribution NonCommercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org
PY - 2021
Y1 - 2021
N2 - Introduction: Hospitalised patients with coronavirus disease 2019 (COVID-19) as a result of SARS-CoV-2 infection have a high mortality rate and frequently require noninvasive respiratory support or invasive ventilation. Optimising and standardising management through evidence-based guidelines may improve quality of care and therefore patient outcomes. Methods: A task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions (pharmacological and non-pharmacological) for the initial version of this “living guideline” using the PICO (population, intervention, comparator, outcome) format. The GRADE approach was used for assessing the quality of evidence and strength of recommendations. Systematic literature reviews were performed, and data pooled by meta-analysis where possible. Evidence tables were presented and evidence to decision frameworks were used to formulate recommendations. Results: Based on the available evidence at the time of guideline development (20 February, 2021), the panel makes a strong recommendation in favour of the use of systemic corticosteroids in patients requiring supplementary oxygen or ventilatory support, and for the use of anticoagulation in hospitalised patients. The panel makes a conditional recommendation for interleukin (IL)-6 receptor antagonist monoclonal antibody treatment and high-flow nasal oxygen or continuous positive airway pressure in patients with hypoxaemic respiratory failure. The panel make strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir. Conditional recommendations are made against the use of azithromycin, hydroxychloroquine combined with azithromycin, colchicine, and remdesivir, in the latter case specifically in patients requiring invasive mechanical ventilation. No recommendation was made for remdesivir in patients requiring supplemental oxygen. Further recommendations for research are made. Conclusion: The evidence base for management of COVID-19 now supports strong recommendations in favour and against specific interventions. These guidelines will be regularly updated as further evidence becomes available.
AB - Introduction: Hospitalised patients with coronavirus disease 2019 (COVID-19) as a result of SARS-CoV-2 infection have a high mortality rate and frequently require noninvasive respiratory support or invasive ventilation. Optimising and standardising management through evidence-based guidelines may improve quality of care and therefore patient outcomes. Methods: A task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions (pharmacological and non-pharmacological) for the initial version of this “living guideline” using the PICO (population, intervention, comparator, outcome) format. The GRADE approach was used for assessing the quality of evidence and strength of recommendations. Systematic literature reviews were performed, and data pooled by meta-analysis where possible. Evidence tables were presented and evidence to decision frameworks were used to formulate recommendations. Results: Based on the available evidence at the time of guideline development (20 February, 2021), the panel makes a strong recommendation in favour of the use of systemic corticosteroids in patients requiring supplementary oxygen or ventilatory support, and for the use of anticoagulation in hospitalised patients. The panel makes a conditional recommendation for interleukin (IL)-6 receptor antagonist monoclonal antibody treatment and high-flow nasal oxygen or continuous positive airway pressure in patients with hypoxaemic respiratory failure. The panel make strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir. Conditional recommendations are made against the use of azithromycin, hydroxychloroquine combined with azithromycin, colchicine, and remdesivir, in the latter case specifically in patients requiring invasive mechanical ventilation. No recommendation was made for remdesivir in patients requiring supplemental oxygen. Further recommendations for research are made. Conclusion: The evidence base for management of COVID-19 now supports strong recommendations in favour and against specific interventions. These guidelines will be regularly updated as further evidence becomes available.
U2 - 10.1183/13993003.00048-2021
DO - 10.1183/13993003.00048-2021
M3 - Review
C2 - 33692120
AN - SCOPUS:85104899730
VL - 57
JO - The European Respiratory Journal
JF - The European Respiratory Journal
SN - 0903-1936
IS - 4
M1 - 2100048
ER -
ID: 281108985