Artículos de revistas
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)
Fecha
2022-03-01Registro en:
Brazilian Journal of Infectious Diseases, v. 26, n. 2, 2022.
1678-4391
1413-8670
10.1016/j.bjid.2022.102347
2-s2.0-85127469982
Autor
Hospital Moinhos de Vento
Universidade Federal do Rio Grande do Sul
McMaster University
Universidade Estadual Paulista (UNESP)
Serviço de Infectologia e Controle de Infecção do Hospital Moinhos de Vento
Serviço de Infectologia do Hospital de Clinicas de Porto Alegre
Universidade de São Paulo (USP)
Universidade Federal da Bahia (UFBA)
Corpometria Institute
Universidade Federal de São Paulo (UNIFESP)
Universidade Federal do Pará (UFPA)
Hospital Sírio-Libanes
Universidade Federal de Sergipe (UFS)
Serviço de Atenção Domiciliar do Hospital Universitário de Santa Maria
Universidade Federal de Santa Catarina (UFSC)
Instituto de Infectologia Emílio Ribas
Associação Beneficência Portuguesa de São Paulo (BP)
Institución
Resumen
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.
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