Publication: European society of clinical microbiology and infectious diseases guidelines for coronavirus disease 2019: an update on treatment of patients with mild/moderate disease.
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Identifiers
Date
2022-08-24
Authors
Bartoletti, Michele
Azap, Ozlem
Barac, Aleksandra
Bussini, Linda
Ergonul, Onder
Krause, Robert
Martin-Quiros, Alejandro
Paño-Pardo, José Ramón
Power, Nicholas
Sibani, Marcella
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Abstract
Despite the large availability of vaccines, coronavirus disease 2019 (COVID-19), induced by severe acute respiratory syndrome coronavirus 2, continues to be a major threat for health-care providers and fragile people. A number of options are now available for outpatients with mild-to-moderate COVID-19 at the risk of disease progression for the prevention of deaths or hospitalization. A European Society of Clinical Microbiology and Infectious Diseases COVID-19 guidelines task force was established by the European Society of Clinical Microbiology and Infectious Diseases Executive Committee. A small group was established, half appointed by the chair and the remaining selected based on an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the population, intervention, comparison, outcome format was developed at the beginning of the process. For each population, intervention, comparison, outcome, two panel members performed a literature search, with a third panelist involved in case of inconsistent results. Voting was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. In this update, we focus on anti-viral agents, monoclonal antibodies (mAbs) and other treatment options proposed for patients with mild or moderate COVID-19 who are at the risk of hospitalization or death. Although the use of anti-virals is recommended, especially nirmatrelvir/ritonavir and remdesivir or, alternatively, molnupirarvir, the administration of mAbs against the spike protein strictly depends on circulating variants or the ability to test timely for variants and sub-variants. At the time of writing (April-June 2022), the only active mAb was tixagevimab/cilgavimab given the predominance of the Omicron BA.2, BA.3, BA.4 and BA.5 sub-lineages in Europe. However, considering that the epidemiological scenario is extremely dynamic, constant monitoring of variants of concern is mandatory.
Description
MeSH Terms
Humans
Antibodies, Monoclonal
Communicable Diseases
Antineoplastic Agents, Immunological
COVID-19 Drug Treatment
Antibodies, Monoclonal
Communicable Diseases
Antineoplastic Agents, Immunological
COVID-19 Drug Treatment
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CIE Terms
Keywords
COVID-19, Cilgavimab, ESCMID, Molnupiravir, Nirmatrelvir/ritonavir, Outpatients, Remdesivir, Sotrovimab, Tixagevimab