COVID-19 - IDSA Treatment Guidelines, Remdesivir, and a Look Back
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In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews regular guest and Infectious Diseases expert Dr. Devang Patel for a discussion of where the IDSA stands on all the potential treatments for COVID-19, a review of the remdesivir paper that is all the rage lately, and a look back on whether or not their very first conversations on the novel coronavirus have stood the test of time.
Recommendation 1
Among patients who have been admitted to the hospital with COVID-19, the IDSA guideline panel recommends hydroxychloroquine/chloroquine in the context of a clinical trial. (Knowledge gap)
Recommendation 2
Among patients who have been admitted to the hospital with COVID-19, the IDSA guideline panel recommends hydroxychloroquine/chloroquine plus azithromycin only in the context of a clinical trial. (Knowledge gap)
Recommendation 3
Among patients who have been admitted to the hospital with COVID-19, the IDSA guideline panel recommends the combination of lopinavir/ritonavir only in the context of a clinical trial. (Knowledge gap)
Recommendation 4
Among patients who have been admitted to the hospital with COVID-19 pneumonia, the IDSA guideline panel suggests against the use of corticosteroids. (Conditional recommendation, very low certainty of evidence)
Recommendation 5
Among patients who have been admitted to the hospital with ARDS due to COVID-19, the IDSA guideline panel recommends the use of corticosteroids in the context of a clinical trial. (Knowledge gap)
Recommendation 6
Among patients who have been admitted to the hospital with COVID-19, the IDSA guideline panel recommends tocilizumab only in the context of a clinical trial. (Knowledge gap)
Recommendation 7
Among patients who have been admitted to the hospital with COVID-19, the IDSA guideline panel recommends COVID-19 convalescent plasma in the context of a clinical trial. (Knowledge gap)
Released 5/12/20
References:
Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/. Published April 11, 2020. Accessed May 2, 2020.
National Institutes of Health. NIH clinical trial shows Remdesivir accelerates recovery from advanced COVID-19. https://www.nih.gov/news-events/news-releases/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19?utm_source=The+Scope&utm_campaign=525dfe3ddf-Weekly_Scope_Jan_12_2018_COPY_01&utm_medium=email&utm_term=0_809ad7d22b-525dfe3ddf-180781593. Published April 29, 2020. Accessed May 2, 2020.
Wang Y, Zhang D, Du G, et al. Remdesivir in adults with severe COVID-19: a randomized, double-blind, placebo-controlled, multi-centre trial. The Lancet. Published April 29, 2020. DOI: https://doi.org/10.1016/S0140-6736(20)31022-9
Patel D, Frayha N. COVID-19 Update. Hippo Education, March 2020. https://www.hippoed.com/pc/rap/episode/bonusshortcovid/covid19update
Patel D, Frayha N. Novel Coronavirus. Hippo Education, January 2020. https://www.hippoed.com/pc/rap/episode/bonusshortnovel/bonusshortnovel