RT Journal Article
T1 Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain
A1 Pérez-Belmonte, Luis M.
A1 López-Carmona, María D.
A1 Quevedo-Marín, Juan L.
A1 Ricci, Michele
A1 Martín-Carmona, Jesica
A1 Sanz-Cánovas, Jaime
A1 López-Sampalo, Almudena
A1 Martín-Escalante, María D.
A1 Bernal-López, M. Rosa
A1 Gómez-Huelgas, Ricardo
K1 Coronavirus disease 2019
K1 Management
K1 Clinical protocol
K1 Differences
K1 Antiviral agent
K1 Corticosteroids
K1 Anakinra
K1 Heparin
K1 Infecciones por coronavirus
K1 Corticosteroides
K1 Andalusia
K1 Antivirales
K1 Protocolos Clínicos
K1 Heparina
K1 Proteína Antagonista del Receptor de Interleucina 1
K1 Andalucía
AB Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence.
PB MDPI
YR 2020
FD 2020-09-19
LK http://hdl.handle.net/10668/3370
UL http://hdl.handle.net/10668/3370
LA en
NO Pérez-Belmonte LM, López-Carmona MD, Quevedo-Marín JL, Ricci M, Martín-Carmona J, Sanz-Cánovas J, et al. Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain. Int J Environ Res Public Health. 2020 Sep 19;17(18):6845.
DS RISalud
RD Apr 6, 2025