Final Up to date: January 14, 2021
The Coronavirus Illness 2019 (COVID-19) Therapy Pointers is revealed in an digital format that may be up to date in keeping with the speedy tempo and rising quantity of data concerning the therapy of COVID-19.
The COVID-19 Therapy Pointers Panel (the Panel) is dedicated to updating this doc to make sure that well being care suppliers, sufferers, and coverage specialists have the latest info concerning the optimum administration of COVID-19 (see the Panel Roster for an inventory of Panel members).
New Pointers sections and suggestions and updates to current Pointers sections are developed by working teams of Panel members. All suggestions included within the Pointers are endorsed by a majority of Panel members (see the Introduction for added particulars on the Pointers improvement course of).
Main revisions to the Pointers throughout the final month are as follows:
January 14, 2021
The COVID-19 Therapy Pointers Panel’s Assertion on the Use of Ivermectin for the Therapy of COVID-19
Because the final revision of the Ivermectin part of the Pointers, outcomes from a number of randomized scientific trials and retrospective cohort research of ivermectin use in sufferers with COVID-19 have been revealed in peer-reviewed journals or made out there as non-peer-reviewed manuscripts. Updates to the Ivermectin part which can be underway will embrace dialogue of those research. As a result of many of those research had vital methodological limitations and incomplete info, the Panel can’t draw definitive conclusions concerning the scientific efficacy of ivermectin for the therapy of COVID-19. As such, the Panel has decided that there are inadequate information to advocate both for or in opposition to using ivermectin for the therapy of COVID-19. Outcomes from adequately powered, well-designed, and well-conducted scientific trials are wanted to supply additional steerage on the function of ivermectin within the therapy of COVID-19.
December 17, 2020
Key Updates to the Pointers
Scientific Spectrum of SARS-CoV-2 An infection
Previously: Scientific Presentation of Folks with SARS-CoV-2 An infection
The Panel expanded the outline and dialogue of persistent signs or organ dysfunction following acute COVID-19 based mostly on the present information of the lingering results of the illness. The Panel famous that extra analysis and rigorous observational cohort research are wanted to raised perceive the pathophysiology and scientific course of those postinfectious sequelae and to establish methods to handle affected sufferers.
Prevention and Prophylaxis of SARS-CoV-2 An infection
This part was up to date with outcomes from two randomized managed trials that studied using hydroxychloroquine as pre-exposure prophylaxis for well being care employees uncovered to extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Antithrombotic Remedy in Sufferers with COVID-19
This part has been up to date based mostly on the latest literature on venous thromboembolism (VTE) as a complication of COVID-19. The general suggestions for using antithrombotic remedy in outpatient and inpatient settings stay unchanged. The subsection on particular concerns throughout being pregnant and lactation has been up to date, together with with extra suggestions on using antithrombotic remedy in sufferers with COVID-19 throughout being pregnant and labor and supply. The next suggestions have been added to this part:
- For pregnant sufferers hospitalized for extreme COVID-19, prophylactic dose anticoagulation is advisable if there aren’t any contraindications to its use (BIII).
- As for nonpregnant sufferers, VTE prophylaxis after hospital discharge just isn’t advisable for pregnant sufferers (AIII). Selections to proceed VTE prophylaxis within the pregnant or postpartum affected person after discharge must be individualized, contemplating concomitant VTE threat elements.
- Anticoagulation remedy use throughout labor and supply requires specialised care and planning. It must be managed in pregnant sufferers with COVID-19 in the same manner as in pregnant sufferers with different situations that require anticoagulation in being pregnant (AIII).
As well as, the Laboratory Analysis subsection of the Important Care part has been eliminated. The knowledge within the part was added to Testing for SARS-CoV-2 An infection.
Extra updates to the Pointers shall be forthcoming in January 2021.