Management of Hospitalized Adult Patients with Coronavirus 2019 (COVID-19): A Therapeutic Guideline

COVID-19, caused by the SARS-CoV-2 strain, is highly contagious and can be fatal in acute cases. In severe cases, hypoxia leads to hypoxemia. In these conditions, oxygen management using ventilation and intubation is very necessary. Optimizing and standardizing treatment management through clinical data can improve the quality of care as well as the patientchr('39')s condition.

In this study, using data from randomized clinical trials and systematic review and meta-analysis, several critical PICOs (population, intervention, comparator, and outcome) were collected. The GRADE approach was also used to evaluate the quality of evidence and the effectiveness of the recommendations derived from the studies.

Based on the available evidence, the following recommendations advised to improve the condition of patients: I) the use of systemic corticosteroids in patients who need oxygen and the use of anticoagulant drugs during hospitalization recommended. II) Treatment of monoclonal antibody (i.e., interleukin -6-receptor antagonist) with oxygen is conditionally recommended in patients with respiratory failure. III) The hydroxychloroquine in combination with lopinavir-ritonavir should not be used in patients with respiratory failure. IV) The use of azithromycin, hydroxychloroquine in combination with azithromycin, colchicine, and remdesivir are recommended temporarily in patients with ventilation. V) Early diagnosis and initiation of treatment have a significant effect on the patientchr('39')s recovery.

The proposed guideline obtained from the evaluation of clinical trials, systematic reviews, and meta-analyses can improve the outcomes of patients with COVID-19 disease.