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Brazilian guidelines for the treatment of outpatients with suspected or confirmed COVID-19. A joint guideline of the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Medical Association (AMB), Brazilian Society of Angiology and Vascular Surgery (SBACV), Brazilian Society of Geriatrics and Gerontology (SBGG), Brazilian Society of Infectious Diseases (SBI), Brazilian Society of Family and Community Medicine (SBFMC), and Brazilian Thoracic Society (SBPT).

Authors :
Falavigna M
Belli KC
Barbosa AN
Zavascki AP
Nastri ACSS
Santana CM
Stein C
Gräf DD
Cadegiani FA
Guimarães HP
Monteiro JT
Ferreira JC
de Azevedo LCP
Magri MMC
Sobreira ML
Dias MBGS
de Oliveira MS
Corradi MFDB
Rosa R
Heinzelmann RS
da Silva RM
Junior RB
Cimerman S
Colpani V
Veiga VC
de Carvalho CRR
Source :
The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases [Braz J Infect Dis] 2022 Mar-Apr; Vol. 26 (2), pp. 102347. Date of Electronic Publication: 2022 Mar 17.
Publication Year :
2022

Abstract

Background: Several therapies have been used or proposed for the treatment of COVID-19, although their effectiveness and safety have not been properly evaluated. The purpose of this document is to provide recommendations to support decisions about the drug treatment of outpatients with COVID-19 in Brazil.<br />Methods: A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines. A rapid guideline development method was used, based on the adoption and/or adaptation of recommendations from existing international guidelines combined with additional structured searches for primary studies and new recommendations whenever necessary (GRADE-ADOLOPMENT). The rating of quality of evidence and the drafting of recommendations followed the GRADE method.<br />Results: Ten technologies were evaluated, and 10 recommendations were prepared. Recommendations were made against the use of anticoagulants, azithromycin, budesonide, colchicine, corticosteroids, hydroxychloroquine/chloroquine alone or combined with azithromycin, ivermectin, nitazoxanide, and convalescent plasma. It was not possible to make a recommendation regarding the use of monoclonal antibodies in outpatients, as their benefit is uncertain and their cost is high, with limitations of availability and implementation.<br />Conclusion: To date, few therapies have demonstrated effectiveness in the treatment of outpatients with COVID-19. Recommendations are restricted to what should not be used, in order to provide the best treatment according to the principles of evidence-based medicine and to promote resource savings by aboiding ineffective treatments.<br />Competing Interests: Conflicts of interest The list of participants and the declaration of conflicts of interest are presented in the Supplementary Material.<br /> (Copyright © 2022 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)

Details

Language :
English
ISSN :
1678-4391
Volume :
26
Issue :
2
Database :
MEDLINE
Journal :
The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
Publication Type :
Academic Journal
Accession number :
35341739
Full Text :
https://doi.org/10.1016/j.bjid.2022.102347