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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Pragmatic Recommendations for Therapeutics of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries

Varun U Shetty1, Brian Jason Brotherton1,2, Andrew Achilleos3

  • 11Critical Care Medicine Department, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

The American Journal of Tropical Medicine and Hygiene
|December 30, 2020
PubMed

Insights

For COVID-19 patients, dexamethasone is recommended for those needing oxygen, but not for others. Treatments like remdesivir and hydroxychloroquine are not advised in low-income countries outside clinical trials.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Limited therapeutic options exist for COVID-19.
  • Numerous clinical trials are underway to evaluate treatments.

Purpose of the Study:

  • To provide evidence-based recommendations for COVID-19 treatments.
  • To guide clinical practice, particularly in low- and middle-income countries (LMICs).

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Development of clinical practice guidelines based on trial evidence.

Main Results:

  • Remdesivir, hydroxychloroquine, and lopinavir-ritonavir are not recommended outside trials in LMICs.
  • Dexamethasone is recommended for adults with severe COVID-19 requiring oxygen.
  • Corticosteroids are recommended for refractory shock; convalescent plasma and IL-6 inhibitors are not recommended outside trials.

Conclusions:

  • Dexamethasone is a key treatment for hospitalized COVID-19 patients.
  • Careful consideration of evidence is crucial for treatment decisions in LMICs.
  • Antimicrobial stewardship is advised for potential coinfections.

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