6533b86dfe1ef96bd12c9786

RESEARCH PRODUCT

Therapeutic strategies for severe COVID-19: a position paper from the Italian Society of Infectious and Tropical Diseases (SIMIT)

Silvia NozzaCristina MussiniGiampiero CarosiAntonio CascioFrancesco MazzottaNicola PetrosilloMarco FalconeRoberto ParrellaPaolo GrossiAntonio ChirianniCarmelo IacobelloEvangelista SagnelliClaudio Maria MastroianniMassimo GalliMarco TinelliMarianna MeschiariMarcello TavioMassimo AndreoniGiovanni Di PerriV. PortelliChiara IariaOrlando ArmignaccoCaterina Sagnelli

subject

0301 basic medicineMicrobiology (medical)medicine.medical_specialtyCoronavirus disease 2019 (COVID-19)030106 microbiologyCoronavirupractice guidelines as topiccoronavirusrandomized controlled trials as topicGuidelinesmedicine.disease_causemedicallaw.invention03 medical and health sciences0302 clinical medicinesocietiesRandomized controlled triallawPandemicitalymedicinepneumonia030212 general & internal medicineIntensive care medicinehumansSocieties MedicalCoronavirustherapySARS-CoV-2business.industryCOVID-19; Coronavirus; Pneumonia; SARS-CoV-2; TherapyStandard treatmentCOVID-19PneumoniaGeneral Medicinecovid-19; coronavirus; pneumonia; sars-cov-2; therapy; covid-19; humans; italy; randomized controlled trials as topic; sars-cov-2; societies medical; standard of care; practice guidelines as topicCOVID-19 Drug TreatmentCoronavirusClinical trialsars-cov-2Infectious Diseasescovid-19standard of carePosition paperObservational studyTherapyCoronavirus; COVID-19; Pneumonia; SARS-CoV-2; TherapybusinessHuman

description

Abstract Scope Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, with conflicting results, has led to rapid changes in treatment guidelines. Our aim was to narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and interpretation of the data by experts who are treating patients in the frontline setting. Methods The panel conducted a detailed review of the literature and eventual press releases from randomized clinical trials for each possible available treatment. Inductive PubMed search waws performed for publications relevant to the topic, including all clinical trials conducted. The result was a flowchart with treatment indications for patients with COVID-19. Implications After 6 months of a pandemic situation and before a possible second coronavirus wave descends on Europe, it is important to evaluate which drugs proved to be effective while also considering that results from many randomized clinical trials are still awaited. Indeed, among treatments for COVID-19, only glucocorticoids have resulted in an association with a significant decrease in mortality in published randomized controlled trials. New therapeutic strategies are urgently needed.

10.1016/j.cmi.2020.12.011http://hdl.handle.net/11573/1529416