Open-source institutional guideline recommendations during the COVID-19 pandemic

Area of Science:

• Infectious Diseases
• Public Health
• Pharmacology

Background:

• The COVID-19 pandemic necessitated rapid development of treatment guidelines.
• Online, open-source guidance from US institutions was rapidly evolving.
• Assessing early recommendations is crucial for understanding treatment evolution.

Purpose of the Study:

• To categorize online, open-source guidance for COVID-19 patient management.
• To determine how US institutions approached treatment recommendations in early pandemic weeks.
• To identify variability in recommended COVID-19 therapies.

Main Methods:

• Conducted a search for open-source, online institutional guidelines for COVID-19 treatment.
• Limited search to US institutions between April 12-22, 2020.
• Compared recommendations for antiviral therapy, corticosteroids, IL-6 inhibitors, and nutritional support.

Main Results:

• 14 out of 105 institutions (13.3%) had available online COVID-19 guidance.
• Supportive care and clinical trial enrollment were universal recommendations.
• Hydroxychloroquine was recommended by 86% of guidelines, with varied dosing and combinations.
• IL-6 inhibitor use often required specialist consultation (89% of institutions).

Conclusions:

• Significant variability exists in COVID-19 treatment and supplemental pharmacologic therapy recommendations.
• Early guidance reflected the evolving understanding of the disease and its management.
• Further research is needed to standardize effective COVID-19 treatment protocols.