Pragmatic Recommendations for Therapeutics of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries.
Am J Trop Med Hyg
; 104(3_Suppl): 48-59, 2020 Dec 29.
Article
in En
| MEDLINE
| ID: mdl-33377451
ABSTRACT
The therapeutic options for COVID-19 patients are currently limited, but numerous randomized controlled trials are being completed, and many are on the way. For COVID-19 patients in low- and middle-income countries (LMICs), we recommend against using remdesivir outside of a clinical trial. We recommend against using hydroxychloroquine ± azithromycin or lopinavir-ritonavir. We suggest empiric antimicrobial treatment for likely coinfecting pathogens if an alternative infectious cause is likely. We suggest close monitoring without additional empiric antimicrobials if there are no clinical or laboratory signs of other infections. We recommend using oral or intravenous low-dose dexamethasone in adults with COVID-19 disease who require oxygen or mechanical ventilation. We recommend against using dexamethasone in patients with COVID-19 who do not require supplemental oxygen. We recommend using alternate equivalent doses of steroids in the event that dexamethasone is unavailable. We also recommend using low-dose corticosteroids in patients with refractory shock requiring vasopressor support. We recommend against the use of convalescent plasma and interleukin-6 inhibitors, such as tocilizumab, for the treatment of COVID-19 in LMICs outside of clinical trials.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Practice Guidelines as Topic
/
Developing Countries
/
Patient Care
/
COVID-19
/
COVID-19 Drug Treatment
Type of study:
Clinical_trials
/
Guideline
Aspects:
Determinantes_sociais_saude
Limits:
Humans
Language:
En
Journal:
Am J Trop Med Hyg
Year:
2020
Document type:
Article