Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020)

Eur Respir Rev. 2020 Oct 5;29(157):200287. doi: 10.1183/16000617.0287-2020. Print 2020 Sep 30.

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research.

Methods: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion.

Results: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder.

Conclusions: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.

Publication types

  • Review

MeSH terms

  • Advisory Committees / organization & administration*
  • Betacoronavirus*
  • COVID-19
  • Consensus*
  • Coronavirus Infections / epidemiology*
  • Europe
  • Humans
  • International Cooperation*
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pulmonary Medicine / standards*
  • SARS-CoV-2
  • Societies, Medical*
  • United States