Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline

Zhikang Ye¹, Bram Rochwerg¹, Ying Wang¹, Neill K Adhikari¹, Srinivas Murthy¹, François Lamontagne¹, Robert A Fowler¹, Haibo Qiu¹, Li Wei¹, Ling Sang¹, Mark Loeb¹, Ning Shen¹, Minhua Huang¹, Zhaonan Jiang¹, Yaseen M Arabi¹, Luis Enrique Colunga-Lozano¹, Li Jiang¹, Younsuck Koh¹, Dong Liu¹, Fang Liu¹, Jason Phua¹, Aizong Shen¹, Tianyi Huo¹, Bin Du², Suodi Zhai¹, Gordon H Guyatt¹

Affiliations

¹ Department of Health Research Methods, Evidence and Impact Canada (Ye, Rochwerg, Guyatt, Colunga-Lozano) and of Medicine (Rochwerg), McMaster University, Hamilton, Ont.; Department of Pharmacy (Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Medicine, Interdepartmental Division of Critical Care Medicine (Adhikari, Fowler), University of Toronto, Toronto, Ont.; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHUS de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Critical Care Medicine (Qiu), Zhongda hospital, School of Medicine, Southeast University, Nanjing, China; Department of Pharmacy (Wei), the First Affiliated Hospital of Guangzhou University of Medical; Department of Critical Care Medicine (Sang), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China; Department of Pathology and Molecular Medicine and Health Research Methods, Evidence, and Impact (Loeb), McMaster University, Hamilton, Ont.; Department of Respiratory and Critical Care Medicine (Shen), Peking University Third Hospital, Beijing, China; Guangdong kuaiwen information technology co. LTD (Huang), Guanzhong, China; Kunshan Guanghui Precise Metal Co. Ltd. (Jiang), Kunshan, China; Intensive Care Department (Arabi), King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Clinical Medicine (Colunga-Lozano), Health Science Center, Universidad de Guadalajara, Guadalajara, Mexico; Department of Critical Care Medicine (Jiang), Xuanwu Hospital, Capital Medical School, Beijing, China; Department of Pulmonary and Critical Care Medicine (Koh), University of Ulsan College of Medicine, Seoul, South Korea; Department of Pharmacy (Liu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Pharmacy (Liu, Zhai), Peking University Third Hospital, Beijing, China; Fast and Chronic Programmes (Phua), Alexandra Hospital, National University Health System, Singapore; Department of Pharmacy, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei (Shen), Anhui, China; General Surgery Department (Huo), Peking University Third Hospital, Beijing, China; Medical Intensive Care Unit (Du), Peking Union Medical College Hospital, Beijing.
² Department of Health Research Methods, Evidence and Impact Canada (Ye, Rochwerg, Guyatt, Colunga-Lozano) and of Medicine (Rochwerg), McMaster University, Hamilton, Ont.; Department of Pharmacy (Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Medicine, Interdepartmental Division of Critical Care Medicine (Adhikari, Fowler), University of Toronto, Toronto, Ont.; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHUS de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Critical Care Medicine (Qiu), Zhongda hospital, School of Medicine, Southeast University, Nanjing, China; Department of Pharmacy (Wei), the First Affiliated Hospital of Guangzhou University of Medical; Department of Critical Care Medicine (Sang), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China; Department of Pathology and Molecular Medicine and Health Research Methods, Evidence, and Impact (Loeb), McMaster University, Hamilton, Ont.; Department of Respiratory and Critical Care Medicine (Shen), Peking University Third Hospital, Beijing, China; Guangdong kuaiwen information technology co. LTD (Huang), Guanzhong, China; Kunshan Guanghui Precise Metal Co. Ltd. (Jiang), Kunshan, China; Intensive Care Department (Arabi), King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Clinical Medicine (Colunga-Lozano), Health Science Center, Universidad de Guadalajara, Guadalajara, Mexico; Department of Critical Care Medicine (Jiang), Xuanwu Hospital, Capital Medical School, Beijing, China; Department of Pulmonary and Critical Care Medicine (Koh), University of Ulsan College of Medicine, Seoul, South Korea; Department of Pharmacy (Liu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Pharmacy (Liu, Zhai), Peking University Third Hospital, Beijing, China; Fast and Chronic Programmes (Phua), Alexandra Hospital, National University Health System, Singapore; Department of Pharmacy, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei (Shen), Anhui, China; General Surgery Department (Huo), Peking University Third Hospital, Beijing, China; Medical Intensive Care Unit (Du), Peking Union Medical College Hospital, Beijing dubin98@gmail.com zhaisuodi@163.com guyatt@mcmaster.ca.

PMID: 32350002
PMCID: PMC7241888
DOI: 10.1503/cmaj.200648

Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline

Zhikang Ye et al. CMAJ. 2020.

. 2020 May 19;192(20):E536-E545.

doi: 10.1503/cmaj.200648. Epub 2020 Apr 29.

Authors

Affiliations

¹ Department of Health Research Methods, Evidence and Impact Canada (Ye, Rochwerg, Guyatt, Colunga-Lozano) and of Medicine (Rochwerg), McMaster University, Hamilton, Ont.; Department of Pharmacy (Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Medicine, Interdepartmental Division of Critical Care Medicine (Adhikari, Fowler), University of Toronto, Toronto, Ont.; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHUS de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Critical Care Medicine (Qiu), Zhongda hospital, School of Medicine, Southeast University, Nanjing, China; Department of Pharmacy (Wei), the First Affiliated Hospital of Guangzhou University of Medical; Department of Critical Care Medicine (Sang), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China; Department of Pathology and Molecular Medicine and Health Research Methods, Evidence, and Impact (Loeb), McMaster University, Hamilton, Ont.; Department of Respiratory and Critical Care Medicine (Shen), Peking University Third Hospital, Beijing, China; Guangdong kuaiwen information technology co. LTD (Huang), Guanzhong, China; Kunshan Guanghui Precise Metal Co. Ltd. (Jiang), Kunshan, China; Intensive Care Department (Arabi), King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Clinical Medicine (Colunga-Lozano), Health Science Center, Universidad de Guadalajara, Guadalajara, Mexico; Department of Critical Care Medicine (Jiang), Xuanwu Hospital, Capital Medical School, Beijing, China; Department of Pulmonary and Critical Care Medicine (Koh), University of Ulsan College of Medicine, Seoul, South Korea; Department of Pharmacy (Liu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Pharmacy (Liu, Zhai), Peking University Third Hospital, Beijing, China; Fast and Chronic Programmes (Phua), Alexandra Hospital, National University Health System, Singapore; Department of Pharmacy, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei (Shen), Anhui, China; General Surgery Department (Huo), Peking University Third Hospital, Beijing, China; Medical Intensive Care Unit (Du), Peking Union Medical College Hospital, Beijing.
² Department of Health Research Methods, Evidence and Impact Canada (Ye, Rochwerg, Guyatt, Colunga-Lozano) and of Medicine (Rochwerg), McMaster University, Hamilton, Ont.; Department of Pharmacy (Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Medicine, Interdepartmental Division of Critical Care Medicine (Adhikari, Fowler), University of Toronto, Toronto, Ont.; Department of Critical Care Medicine and Sunnybrook Research Institute (Adhikari, Fowler), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHUS de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Critical Care Medicine (Qiu), Zhongda hospital, School of Medicine, Southeast University, Nanjing, China; Department of Pharmacy (Wei), the First Affiliated Hospital of Guangzhou University of Medical; Department of Critical Care Medicine (Sang), the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, China; Department of Pathology and Molecular Medicine and Health Research Methods, Evidence, and Impact (Loeb), McMaster University, Hamilton, Ont.; Department of Respiratory and Critical Care Medicine (Shen), Peking University Third Hospital, Beijing, China; Guangdong kuaiwen information technology co. LTD (Huang), Guanzhong, China; Kunshan Guanghui Precise Metal Co. Ltd. (Jiang), Kunshan, China; Intensive Care Department (Arabi), King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Clinical Medicine (Colunga-Lozano), Health Science Center, Universidad de Guadalajara, Guadalajara, Mexico; Department of Critical Care Medicine (Jiang), Xuanwu Hospital, Capital Medical School, Beijing, China; Department of Pulmonary and Critical Care Medicine (Koh), University of Ulsan College of Medicine, Seoul, South Korea; Department of Pharmacy (Liu), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Pharmacy (Liu, Zhai), Peking University Third Hospital, Beijing, China; Fast and Chronic Programmes (Phua), Alexandra Hospital, National University Health System, Singapore; Department of Pharmacy, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei (Shen), Anhui, China; General Surgery Department (Huo), Peking University Third Hospital, Beijing, China; Medical Intensive Care Unit (Du), Peking Union Medical College Hospital, Beijing dubin98@gmail.com zhaisuodi@163.com guyatt@mcmaster.ca.

PMID: 32350002
PMCID: PMC7241888
DOI: 10.1503/cmaj.200648

No abstract available

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Conflict of interest statement

Competing interests: Younsuck Koh, Bin Du and Yaseen Arabi report being authors of Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults With Coronavirus Disease 2019, which made 1 recommendation relevant to this guideline regarding corticosteroids in acute respiratory distress syndrome. Bin Du reports being the principal investigator of an ongoing prospective randomized controlled trial (RCT) examining the efficacy of corticosteroids in patients with moderate-to-severe coronavirus disease 2019 (COVID-19), which is funded by the research grant 2020YFC0841300 from the Ministry of Science and Technology of the People’s Republic of China. Srinivas Murthy and Robert Fowler report being investigators in a trial, supported by a Canadian Institutes of Health Research (CIHR) grant, evaluating the effect of corticosteroids and antiviral drugs (hydroxychloroquine and lopinavir-ritonavir) in patients with COVID-19. Ning Shen reports being an investigator in a trial evaluating the effect of hydroxychloroquine in patients with COVID-19, funded by Peking University Health Science Center. Neill Adhikari reports being a co-investigator of a CIHR-funded grant of antivirals in hospitalized patients with COVID-19 and of a second CIHR-funded grant of a variety of treatments, including corticosteroids, in critically ill patients with COVID-19. Mark Loeb reports receiving a grant and personal fees from the World Health Organization (WHO) for contract work on influenza and antibiotic resistance; consulting fees and a grant from Seqirus for an RCT on influenza; personal fees as a member of the advisory board and non-financial support from Sanofi, for an in-kind vaccine for the influenza RCT; and consulting fees from Pfizer and Medicago. Dr. Loeb also reports being an investigator in a trial evaluating the effect of chloroquine-azithromycin in patients with COVID-19, funded by Ontario Ministry of Health, Bayer and Abbott. François Lamontagne and Bram Rochwerg report being investigators in a trial, supported by a CIHR grant, evaluating the effect of corticosteroids and antiviral drugs (hydroxychloroquine and lopinavir-ritonavir) in patients with COVID-19. No other competing interests were declared.

References

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Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline

Affiliations

Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline

Authors

Affiliations

Conflict of interest statement

References

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LinkOut - more resources

Full Text Sources

Medical