Making treatment decisions in a void of information.

Abstract

It is early March 2020, and Dr. A is attending a patient admitted to her ward with severe COVID-19. The patient , Mr. X, a 75-year-old male with hypertension and mild obesity , had been admitted to the hospital with bilateral pneumonia and 85% oxygen saturation while breathing room air . In previous days, more than 100 patients with COVID-19 had been admitted at Dr. A’s hospital , among whom 15 needed admission to the intensive care unit and 10 had already died. That same morning, a colleague had presented a literature review on treatment options for COVID-19. The conclusion was that no good-level evidence for the efficacy of any treatment for that condition existed, but some in vitro data and small observational studies (some in preprint form) suggested that some drugs could work . A critical review of those studies indicated a high risk of bias .