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A living WHO guideline on drugs to prevent COVID-19
Lamontagne, François; Agoritsas, Thomas; Siemieniuk, Reed; Rochwerg, Bram; Bartoszko, Jessica; Askie, Lisa; Macdonald, Helen; Amin, Wagdy; Bausch, Frederique Jacquerioz; Burhan, Erlina; Cecconi, Maurizio; chanda, Duncan; Quoc Dat, Vu; Du, Bin; Geduld, Heike; Gee, Patrick; Nerina, Harley; Hashimi, Madiha; Hunt, Beverley; Kabra, Sushil; Kanda, Seema; Kawano-Dourado, Leticia; Kim, Yae-Jean; Kissoon, Niranjan; Kwizera, Arthur; Leo, Yee-Sin; Mahaka, Imelda; Manai, Hela; Mino, Greta; Nsutebu, Emmanuel; Pshenichnaya, Natalia; Qadir, Nida; Ranganathan, Shalini Sri; Sabzwari, Saniya; Sarin, Rohit; Sharland, Michael; Shen, Yinzhong; Souza, Joao; Stegemman, Miriam; Ugarte, Sebastian; Venkatapuram, Sridhar; Vuyiseka, Dubula; Preller, Jacobus; Brignardello-Petersen, Romina; Kum, Elena; Qasim, Lyubov; Zeraatkar, Dena; Owen, Andrew; Guyatt, Gordon; Lytvyn, Lyubov; Diaz, Janet; Vandvik, Per; Jacobs, Michael.
Afiliação
  • Lamontagne, François; Université de Sherbrooke. Centre de recherche due CHU de Sherbrooke. Sherbrooke. CA
  • Agoritsas, Thomas; University Hospitals of Geneva. Division of General Internal Medicine. Division of Clinical Epidemiology. Geneva. SZ
  • Siemieniuk, Reed; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Rochwerg, Bram; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Bartoszko, Jessica; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Askie, Lisa; World Health Organization. Geneva. SZ
  • Macdonald, Helen; BMJ. London. GB
  • Amin, Wagdy; Ministry of Health and Population. Cairo. EG
  • Bausch, Frederique Jacquerioz; Geneva University Hospital. SZ
  • Burhan, Erlina; Universitas Indonesia. Faculty of Medicine. Department of Pulmonology and Respiratory Medicine. ID
  • Cecconi, Maurizio; Humanitas Clinical and Research Center-IRCCS. Department of Anesthesia and Intensive Care Medicine. Rozzano. IT
  • chanda, Duncan; University Teaching Hospital. Adult Infectious Disease Centre. Lusaka. ZM
  • Quoc Dat, Vu; Hanoi Medical University. Department of Infectious Diseases. Hanoi. VN
  • Du, Bin; Peking Union Medical College Hospital. Beijing. CN
  • Geduld, Heike; Stellenbosch University. Faculty of Medicine and Health Sciences. Division of Emergency Medicine. Cape Town. ZA
  • Gee, Patrick; s.af
  • Nerina, Harley; Royal Melbourne Hospital. Melbourne. AU
  • Hashimi, Madiha; Ziauddin University. Karachi. PK
  • Hunt, Beverley; Guy's & St Thomas' NHS Foundation Trust. London. GB
  • Kabra, Sushil; All India Institute of Medical Sciences. New Delhi, India. IN
  • Kanda, Seema; McMaster University. Hamilton. CA
  • Kawano-Dourado, Leticia; University of Sao Paulo. Medical School. Pulmonary Division, Heart Institute (InCor). São Paulo. BR
  • Kim, Yae-Jean; Samsung Medical Center. Sungkyunkwan University School of Medicine. Seoul. KR
  • Kissoon, Niranjan; University of British Columbia. Department of Paediatrics and Emergency Medicine. Vancouver. CA
  • Kwizera, Arthur; Makerere University. College of Health Sciences. Department of Anaesthesia and Critical Care. Kampala. UG
  • Leo, Yee-Sin; National Center for Infectious Diseases. SG
  • Mahaka, Imelda; Pangaea Harare. ZW
  • Manai, Hela; Emergency Medical Services. Faculty of Medicine. TN
  • Mino, Greta; Alcivar Hospital, Guayaquil. EC
  • Nsutebu, Emmanuel; Sheikh Shakhbout Medical City. Abu Dhabi. AE
  • Pshenichnaya, Natalia; Central Research Institute of Epidemiology of Rospotrebnadzor. Moscow. RU
  • Qadir, Nida; University of California Los Angeles. David Geffen School of Medicine. Division of Pulmonary and Critical Care Medicine. Los Angeles. US
  • Ranganathan, Shalini Sri; University of Colombo. Colombo. LK
  • Sabzwari, Saniya; Aga Khan University. Karachi. PK
  • Sarin, Rohit; National Institute of Tuberculosis and Respiratory Diseases,. New Delhi. IN
  • Sharland, Michael; St. George's University Hospital. London. GB
  • Shen, Yinzhong; Shanghai Public Health Clinical Center. Fudan University. Shanghai. CN
  • Souza, Joao; University of Sao Paulo. Sao Paulo. BR
  • Stegemman, Miriam; Charité - Universitätsmedizin. Berlin. DE
  • Ugarte, Sebastian; Andres Bello University. Faculty of Medicine. Indisa Clinic. Santiago. CL
  • Venkatapuram, Sridhar; King's College. London. GB
  • Vuyiseka, Dubula; University of Stellenbosch. ZA
  • Preller, Jacobus; World Health Organization. Geneva. SZ
  • Brignardello-Petersen, Romina; McMaster University. Department of Health Research Methods, Evidence and Impac. Hamilton. CA
  • Kum, Elena; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Qasim, Lyubov; McMaster University, Hamilton. Department of Health Research Methods, Evidence and Impact. Ontario. CA
  • Zeraatkar, Dena; McMaster University. Department of Health Research Methods, Evidence and Impact. Ontario. CA
  • Owen, Andrew; University of Liverpool. Liverpool. GB
  • Guyatt, Gordon; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Lytvyn, Lyubov; McMaster University. Department of Health Research Methods, Evidence and Impact. Hamilton. CA
  • Diaz, Janet; World Health Organization. Geneva. SZ
  • Vandvik, Per; MAGIC Evidence Ecosystem Foundation. Oslo. NO
  • Jacobs, Michael; Royal Free London NHS Foundation Trust. London. GB
BMJ (Online) ; 372(526): 1-5, Mar. 2, 2021. tab
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1281892
Biblioteca responsável: BR1.1
ABSTRACT
Clinical question What is the role of drugs in preventing covid-19? Why does this matter?There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline.
Assuntos

Texto completo: Disponível Coleções: Bases de dados temática Contexto em Saúde: ODS3 - Saúde e Bem-Estar / ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis / ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Meta 3.8 Atingir a cobertura universal de saúde / COVID-19 / Pneumonía / Outras Doenças Respiratórias Base de dados: BIGG - guias GRADE Assunto principal: SARS-CoV-2 / COVID-19 / Hidroxicloroquina Tipo de estudo: Guia de prática clínica Aspecto: Aspectos éticos Idioma: Inglês Revista: BMJ (Online) Ano de publicação: 2021 Tipo de documento: Artigo Instituição/País de afiliação: Aga Khan University/PK / Alcivar Hospital, Guayaquil/EC / All India Institute of Medical Sciences/IN / Andres Bello University/CL / BMJ/GB / Central Research Institute of Epidemiology of Rospotrebnadzor/RU / Charité - Universitätsmedizin/DE / Emergency Medical Services/TN / Geneva University Hospital/SZ / Guy's & St Thomas' NHS Foundation Trust/GB

Texto completo: Disponível Coleções: Bases de dados temática Contexto em Saúde: ODS3 - Saúde e Bem-Estar / ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis / ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Meta 3.8 Atingir a cobertura universal de saúde / COVID-19 / Pneumonía / Outras Doenças Respiratórias Base de dados: BIGG - guias GRADE Assunto principal: SARS-CoV-2 / COVID-19 / Hidroxicloroquina Tipo de estudo: Guia de prática clínica Aspecto: Aspectos éticos Idioma: Inglês Revista: BMJ (Online) Ano de publicação: 2021 Tipo de documento: Artigo Instituição/País de afiliação: Aga Khan University/PK / Alcivar Hospital, Guayaquil/EC / All India Institute of Medical Sciences/IN / Andres Bello University/CL / BMJ/GB / Central Research Institute of Epidemiology of Rospotrebnadzor/RU / Charité - Universitätsmedizin/DE / Emergency Medical Services/TN / Geneva University Hospital/SZ / Guy's & St Thomas' NHS Foundation Trust/GB
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