Coronavirus Disease 2019 (COVID-19) Treatment Guidelines

Coronavirus Disease 2019 (COVID-19) Treatment Guidelines

October 9, 2020

New Sections of the Guidelines

Therapeutic Management of Patients with COVID-19

This section provides recommendations for the treatment of COVID-19 based on the severity of disease. It includes recommendations for the use of remdesivir, an antiviral agent that targets severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and dexamethasone, a corticosteroid that reduces inflammation. A new figure (Figure 1) outlines the Panel’s recommendations. The Panel also discusses the rationale that led to each recommendation, including theoretical reasons for administering combination therapy in some situations.

Special Considerations in People with Human Immunodeficiency Virus

This section discusses the prevention, diagnosis, and management of COVID-19 in people with human immunodeficiency virus (HIV). The Panel emphasizes that recommendations for the triage, management, and treatment of COVID-19 in people with HIV are the same as those for the general population. The Panel also recommends continuing antiretroviral therapy and prophylaxis for opportunistic infections whenever possible in people with HIV who develop COVID-19, including in those who require hospitalization (AIII).

Key Updates to the Guidelines

Clinical Presentation of People with SARS-CoV-2 Infection

A new subsection entitled Persistent Symptoms or Illnesses After Recovery from Acute COVID-19 was added to this section to describe the emerging data on these symptoms. The Panel notes that more research is needed to better understand the pathophysiology and clinical course of these post-infection sequelae and to identify management strategies for patients.

General Considerations for Critically Ill Patients with COVID-19

Two new subsections have been added to this section. Sedation Management in Patients with COVID-19 provides guidance to the members of the intensive care unit (ICU) team on following international guidelines for the prevention, detection, and treatment of pain, sedation, and delirium. The other new subsection, Post-Intensive Care Syndrome, describes a spectrum of cognitive, psychiatric, and/or

physical disabilities that affects survivors of critical illness and persists after a patient leaves the ICU.

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