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Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19
Adarsh Bhimraj1, Rebecca L Morgan2,3, Amy Hirsch Shumaker3,4
1Division of Infectious Diseases, Houston Methodist Hospital, Houston, Texas, USA.
Abstract:
There are many pharmacologic therapies that are being used or considered for treatment of coronavirus disease 2019 (COVID-19), with rapidly changing efficacy and safety evidence from trials. The objective was to develop evidence-based, rapid, living guidelines intended to support patients, clinicians, and other healthcare professionals in their decisions about treatment and management of patients with COVID-19. In March 2020, the Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise to regularly review the evidence and make recommendations about the treatment and management of persons with COVID-19. The process used a living guideline approach and followed a rapid recommendation development checklist. The panel prioritized questions and outcomes. A systematic review of the peer-reviewed and grey literature was conducted at regular intervals. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. Based on the most recent search conducted on 31 May 2022, the IDSA guideline panel has made 32 recommendations for the treatment and management of the following groups/populations: pre- and postexposure prophylaxis, ambulatory with mild-to-moderate disease, and hospitalized with mild-to-moderate, severe but not critical, and critical disease. As these are living guidelines, the most recent recommendations can be found online at: https://idsociety.org/COVID19guidelines. At the inception of its work, the panel has expressed the overarching goal that patients be recruited into ongoing trials. Since then, many trials were conducted that provided much-needed evidence for COVID-19 therapies. There still remain many unanswered questions as the pandemic evolved, which we hope future trials can answer.
Insights
The Infectious Diseases Society of America developed rapid, living guidelines for COVID-19 treatment, offering 32 evidence-based recommendations for various patient groups. These guidelines support clinical decisions amidst evolving evidence on coronavirus disease 2019 therapies.
Area of Science:
- Infectious Diseases
- Clinical Practice Guidelines
- Evidence-Based Medicine
Background:
- Numerous pharmacologic therapies are under investigation for coronavirus disease 2019 (COVID-19), with rapidly evolving evidence on their efficacy and safety.
- The need for timely, evidence-based guidance for managing COVID-19 patients is critical for healthcare professionals and patients.
Purpose of the Study:
- To develop and disseminate rapid, living, evidence-based guidelines for the treatment and management of COVID-19.
- To support clinical decision-making for diverse patient populations affected by COVID-19.
Main Methods:
- A multidisciplinary guideline panel was convened by the Infectious Diseases Society of America (IDSA) in March 2020.
- A living guideline approach was employed, including systematic literature reviews and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
- Recommendations were developed for pre- and postexposure prophylaxis, ambulatory, and hospitalized patients with varying disease severity.
Main Results:
- The IDSA guideline panel issued 32 recommendations based on evidence reviewed up to May 31, 2022.
- Recommendations cover prophylaxis, mild-to-moderate ambulatory disease, and mild-to-moderate, severe, and critical hospitalized disease.
- The guidelines are continuously updated and available online to reflect the latest evidence.
Conclusions:
- Living guidelines provide essential, up-to-date recommendations for COVID-19 treatment and management.
- Ongoing clinical trials remain crucial for addressing remaining questions and advancing COVID-19 therapy.
- The guidelines aim to optimize patient care by integrating the best available evidence into clinical practice.
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