Management of hospitalised adults with coronavirus disease 2019 (COVID-19) : a European Respiratory Society living guideline
Copyright ©The authors 2021..
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.
| Errataetall: |
CommentIn: Eur Respir J. 2021 Apr 15;57(4):. - PMID 33766949 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:57 |
|---|---|
| Enthalten in: |
The European respiratory journal - 57(2021), 4 vom: 08. Apr. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chalmers, James D [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adrenal Cortex Hormones |
|---|
| Anmerkungen: |
Date Completed 20.04.2021 Date Revised 11.11.2023 published: Electronic-Print CommentIn: Eur Respir J. 2021 Apr 15;57(4):. - PMID 33766949 Citation Status MEDLINE |
|---|
| doi: |
10.1183/13993003.00048-2021 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM322492149 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM322492149 | ||
| 003 | DE-627 | ||
| 005 | 20231225182144.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1183/13993003.00048-2021 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1074.xml |
| 035 | |a (DE-627)NLM322492149 | ||
| 035 | |a (NLM)33692120 | ||
| 035 | |a (PII)2100048 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chalmers, James D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Management of hospitalised adults with coronavirus disease 2019 (COVID-19) |b a European Respiratory Society living guideline |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.04.2021 | ||
| 500 | |a Date Revised 11.11.2023 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a CommentIn: Eur Respir J. 2021 Apr 15;57(4):. - PMID 33766949 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright ©The authors 2021. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Practice Guideline | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 700 | 1 | |a Crichton, Megan L |e verfasserin |4 aut | |
| 700 | 1 | |a Goeminne, Pieter C |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Humbert, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Shteinberg, Michal |e verfasserin |4 aut | |
| 700 | 1 | |a Antoniou, Katerina M |e verfasserin |4 aut | |
| 700 | 1 | |a Ulrik, Charlotte Suppli |e verfasserin |4 aut | |
| 700 | 1 | |a Parks, Helen |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Vandendriessche, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Qu, Jieming |e verfasserin |4 aut | |
| 700 | 1 | |a Stolz, Daiana |e verfasserin |4 aut | |
| 700 | 1 | |a Brightling, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Welte, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Aliberti, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Simonds, Anita K |e verfasserin |4 aut | |
| 700 | 1 | |a Tonia, Thomy |e verfasserin |4 aut | |
| 700 | 1 | |a Roche, Nicolas |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The European respiratory journal |d 1989 |g 57(2021), 4 vom: 08. Apr. |w (DE-627)NLM012664782 |x 0903-1936 |7 nnns |
| 773 | 1 | 8 | |g volume:57 |g year:2021 |g number:4 |g day:08 |g month:04 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1183/13993003.00048-2021 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 57 |j 2021 |e 4 |b 08 |c 04 | ||