Remdesivir for severe covid-19: a clinical practice guideline

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dc.contributor.authorRochwerg, Bramen_ZA
dc.contributor.authorAgarwal, Arnaven_ZA
dc.contributor.authorZeng, Linanen_ZA
dc.contributor.authorLeo, Yee-Sinen_ZA
dc.contributor.authorAppiah, John Adabieen_ZA
dc.contributor.authorAgoritsas, Thomasen_ZA
dc.contributor.authorBartoszko, Jessicaen_ZA
dc.contributor.authorBrignardello-Petersen, Rominaen_ZA
dc.contributor.authorErgan, Begumen_ZA
dc.contributor.authorGe, Longen_ZA
dc.contributor.authorGeduld, Heikeen_ZA
dc.contributor.authorGershengorn, Hayley B.en_ZA
dc.contributor.authorManai, Helaen_ZA
dc.contributor.authorHuang, Minhuaen_ZA
dc.contributor.authorLamontagne, Françoisen_ZA
dc.contributor.authorKanda, Seemaen_ZA
dc.contributor.authorKawano-Dourado, Leticiaen_ZA
dc.contributor.authorKurian, Lindaen_ZA
dc.contributor.authorKwizera, Arthuren_ZA
dc.contributor.authorMurthy, Srinivasen_ZA
dc.contributor.authorQadir, Nidaen_ZA
dc.contributor.authorSiemieniuk, Reeden_ZA
dc.contributor.authorSilvestre, Maria Asuncionen_ZA
dc.contributor.authorVandvik, Per Olaven_ZA
dc.contributor.authorYe, Zhikangen_ZA
dc.contributor.authorZeraatkar, Denaen_ZA
dc.contributor.authorGuyatt, Gordonen_ZA
dc.date.accessioned2022-05-30T07:35:14Z
dc.date.available2022-05-30T07:35:14Z
dc.date.issued2020-11
dc.description.abstractClinical question What is the role of remdesivir in the treatment of severe covid-19? This guideline was triggered by the ACTT-1 trial published in the New England Journal of Medicine on 22 May 2020. Current practice Remdesivir has received worldwide attention as a potentially effective treatment for severe covid-19. After rapid market approval in the US, remdesivir is already being used in clinical practice. Recommendations The guideline panel makes a weak recommendation for the use of remdesivir in severe covid-19 while recommending continuation of active enrolment of patients into ongoing randomised controlled trials examining remdesivir. How this guideline was created An international panel of patients, clinicians, and methodologists produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The recommendations are based on a linked systematic review and network meta-analysis. The panel considered an individual patient perspective and allowed contextual factors (such as resources) to be taken into account for countries and healthcare systems. The evidence The linked systematic review (published 31 Jul 2020) identified two randomised trials with 1300 participants, showing low certainty evidence that remdesivir may be effective in reducing time to clinical improvement and may decrease mortality in patients with severe covid-19. Remdesivir probably has no important effect on need for invasive mechanical ventilation. Remdesivir may have little or no effect on hospital length of stay. Understanding the recommendation Most patients with severe covid-19 would likely choose treatment with remdesivir given the potential reduction in time to clinical improvement. However, given the low certainty evidence for critical outcomes and the fact that different perspectives, values, and preferences may alter decisions regarding remdesivir, the panel issued a weak recommendation with strong support for continued recruitment in randomised trials.en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125259
dc.language.isoen_ZAen_ZA
dc.subjectCOVID-19 (Disease) -- Treatmenten_ZA
dc.subjectAntiviral agentsen_ZA
dc.subjectDrugs -- Physiological effecten_ZA
dc.titleRemdesivir for severe covid-19: a clinical practice guidelineen_ZA
dc.typeArticleen_ZA
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