Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020).
Bai C., Chotirmall SH., Rello J., Alba GA., Ginns LC., Krishnan JA., Rogers R., Bendstrup E., Burgel P-R., Chalmers JD., Chua A., Crothers KA., Duggal A., Kim YW., Laffey JG., Luna CM., Niederman MS., Raghu G., Ramirez JA., Riera J., Roca O., Tamae-Kakazu M., Torres A., Watkins RR., Barrecheguren M., Belliato M., Chami HA., Chen R., Cortes-Puentes GA., Delacruz C., Hayes MM., Heunks LMA., Holets SR., Hough CL., Jagpal S., Jeon K., Johkoh T., Lee MM., Liebler J., McElvaney GN., Moskowitz A., Oeckler RA., Ojanguren I., O'Regan A., Pletz MW., Rhee CK., Schultz MJ., Storti E., Strange C., Thomson CC., Torriani FJ., Wang X., Wuyts W., Xu T., Yang D., Zhang Z., Wilson KC.
BackgroundCoronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research.MethodsAn International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion.ResultsThe Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder.ConclusionsThe Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.