THURSDAY, April 9, 2020 (HealthDay News) -- In a guidance document issued by the American Thoracic Society, interim recommendations are presented for management of coronavirus disease 2019 (COVID-19).
On behalf of the American Thoracic Society-led International Task Force on COVID-19, Kevin C. Wilson, M.D., from the Boston University School of Medicine, and colleagues present consensus suggestions on controversial topics based on scarce direct evidence, indirect evidence, and clinical observations.
The researchers recommend collecting data and comparing outcomes for COVID-19 patients receiving and not receiving interventions. For patients with COVID-19 well enough to be managed as outpatients and for hospitalized COVID-19 patients with no evidence of pneumonia, no suggestion is made for or against hydroxychloroquine or chloroquine. For hospitalized patients with COVID-19 with evidence of pneumonia, hydroxychloroquine (or chloroquine) is suggested on a case-by-case basis if shared decision making is conducted, the patient's clinical condition is severe enough to warrant investigational therapy, and if there is no shortage of drug supply. No suggestion is made for or against remdesivir, lopinavir-ritonavir, tocilizumab, or systemic corticosteroids for hospitalized patients with evidence of pneumonia. Prone ventilation is recommended for patients with refractory hypoxemia due to progressive COVID-19 pneumonia. Extracorporeal membrane oxygenation should be considered if prone ventilation fails for patients with refractory hypoxemia due to progressive COVID-19 pneumonia.
"Supportive care remains the mainstay of treatment and social distancing remains an important part of prevention," the authors write. "The suggestions provided in this document will be periodically reevaluated as new evidence emerges and modified accordingly."