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)
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 CO...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-03-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867022000356 |
| _version_ | 1818232139423940608 |
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| author | Maicon Falavigna Karlyse Claudino Belli Alexandre Naime Barbosa Alexandre Prehn Zavascki Ana Catharina de Seixas Santos Nastri Christiane Machado Santana Cinara Stein Débora Dalmas Gräf Flavio Adsuara Cadegiani Hélio Penna Guimarães José Tadeu Monteiro Juliana Carvalho Ferreira Luciano Cesar Pontes de Azevedo Marcelo Mihailenko Chaves Magri Marcone Lima Sobreira Maria Beatriz Gandra de Souza Dias Maura Salaroli de Oliveira Mirian de Freitas Dal Ben Corradi Regis Rosa Ricardo Souza Heinzelmann Rosemeri Maurici da Silva Rubens Belfort Junior Sergio Cimerman Verônica Colpani Viviane Cordeiro Veiga Carlos Roberto Ribeiro de Carvalho |
| author_facet | Maicon Falavigna Karlyse Claudino Belli Alexandre Naime Barbosa Alexandre Prehn Zavascki Ana Catharina de Seixas Santos Nastri Christiane Machado Santana Cinara Stein Débora Dalmas Gräf Flavio Adsuara Cadegiani Hélio Penna Guimarães José Tadeu Monteiro Juliana Carvalho Ferreira Luciano Cesar Pontes de Azevedo Marcelo Mihailenko Chaves Magri Marcone Lima Sobreira Maria Beatriz Gandra de Souza Dias Maura Salaroli de Oliveira Mirian de Freitas Dal Ben Corradi Regis Rosa Ricardo Souza Heinzelmann Rosemeri Maurici da Silva Rubens Belfort Junior Sergio Cimerman Verônica Colpani Viviane Cordeiro Veiga Carlos Roberto Ribeiro de Carvalho |
| author_sort | Maicon Falavigna |
| collection | DOAJ |
| description | 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. 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. 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. 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. |
| first_indexed | 2024-12-12T11:01:32Z |
| format | Article |
| id | doaj.art-279515689ab34aed9b93c8bcf7240154 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-12T11:01:32Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-279515689ab34aed9b93c8bcf72401542022-12-22T00:26:32ZengElsevierBrazilian Journal of Infectious Diseases1413-86702022-03-01262102347Brazilian 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)Maicon Falavigna0Karlyse Claudino Belli1Alexandre Naime Barbosa2Alexandre Prehn Zavascki3Ana Catharina de Seixas Santos Nastri4Christiane Machado Santana5Cinara Stein6Débora Dalmas Gräf7Flavio Adsuara Cadegiani8Hélio Penna Guimarães9José Tadeu Monteiro10Juliana Carvalho Ferreira11Luciano Cesar Pontes de Azevedo12Marcelo Mihailenko Chaves Magri13Marcone Lima Sobreira14Maria Beatriz Gandra de Souza Dias15Maura Salaroli de Oliveira16Mirian de Freitas Dal Ben Corradi17Regis Rosa18Ricardo Souza Heinzelmann19Rosemeri Maurici da Silva20Rubens Belfort Junior21Sergio Cimerman22Verônica Colpani23Viviane Cordeiro Veiga24Carlos Roberto Ribeiro de Carvalho25Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil; Instituto de Avaliação de Tecnologia em Saúde (IATS), Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; Corresponding author at: Projeto Diretrizes, Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630 / 1015, Porto Alegre, RS, Brazil, Postal code: 90035-001.Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, BrazilUNESP – Faculdade de Medicina, Departamento de Infectologia, BrazilServiço de Infectologia e Controle de Infecção do Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil; Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Serviço de Infectologia do Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, BrazilUniversidade Federal da Bahia (UFBA), Bahia, BrazilHospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, BrazilHospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, BrazilCorpometria Institute, Brasília, BrazilEscola Paulista de Medicina (UNIFESP-EPM), São Paulo, BrazilUniversidade Federal do Pará, Pará, BrazilInstituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Sírio-Libanes, São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Sírio-Libanes, São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB/UNESP), São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Sírio-Libanes, São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Sírio-Libanes, São Paulo, BrazilHospital Sírio-Libanes, São Paulo, BrazilHospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, BrazilDepartamento de Saúde Coletiva da Universidade Federal de Santa Maria (UFSM), Rio Grande do Sul, Brazil; Serviço de Atenção Domiciliar do Hospital Universitário de Santa Maria, Rio Grande do Sul, BrazilUniversidade Federal de Santa Catarina (UFSC), Santa Catarina, BrazilHospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB/UNESP), São Paulo, BrazilInstituto de Infectologia Emílio Ribas, BrazilHospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, BrazilAssociação Beneficência Portuguesa de São Paulo (BP), São Paulo, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Hospital Sírio-Libanes, São Paulo, BrazilABSTRACT: 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. 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. 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. 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.http://www.sciencedirect.com/science/article/pii/S1413867022000356COVID-19COVID-19 drug treatmentGuidelineSARS-CoV-2BrazilGRADE |
| spellingShingle | Maicon Falavigna Karlyse Claudino Belli Alexandre Naime Barbosa Alexandre Prehn Zavascki Ana Catharina de Seixas Santos Nastri Christiane Machado Santana Cinara Stein Débora Dalmas Gräf Flavio Adsuara Cadegiani Hélio Penna Guimarães José Tadeu Monteiro Juliana Carvalho Ferreira Luciano Cesar Pontes de Azevedo Marcelo Mihailenko Chaves Magri Marcone Lima Sobreira Maria Beatriz Gandra de Souza Dias Maura Salaroli de Oliveira Mirian de Freitas Dal Ben Corradi Regis Rosa Ricardo Souza Heinzelmann Rosemeri Maurici da Silva Rubens Belfort Junior Sergio Cimerman Verônica Colpani Viviane Cordeiro Veiga Carlos Roberto Ribeiro de Carvalho 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) Brazilian Journal of Infectious Diseases COVID-19 COVID-19 drug treatment Guideline SARS-CoV-2 Brazil GRADE |
| title | 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | COVID-19 COVID-19 drug treatment Guideline SARS-CoV-2 Brazil GRADE |
| url | http://www.sciencedirect.com/science/article/pii/S1413867022000356 |
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