Dept of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.
Shanghai Respiratory Research Institution, Shanghai, China.
Eur Respir Rev. 2020 Oct 5;29(157). doi: 10.1183/16000617.0287-2020. Print 2020 Sep 30.
Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research.
An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion.
The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder.
The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.
2019 年冠状病毒病（COVID-19）是由严重急性呼吸系统综合征冠状病毒 2 引起的疾病。共识建议可以规范护理，从而改善结果并促进未来的研究。
组成了一个国际工作组，并使用共识意见和证据（CORE）过程来衡量对行动方案的一致性。需要 70%的一致性才能提出共识建议。
工作组就治疗急性 COVID-19 肺炎患者的瑞德西韦和地塞米松提出了共识建议，但建议除非在临床试验的情况下，否则不要使用羟氯喹；这是根据几项随机试验的中期发表结果对先前建议的修订。它还建议对患有静脉血栓栓塞事件的 COVID-19 患者进行 3 个月的治疗性抗凝治疗。工作组未能达成足够的一致意见，无法就 COVID-19 幸存者的出院后护理提出共识建议。工作组在建议常规筛查抑郁、焦虑和创伤后应激障碍方面仅差一票。
工作组针对 COVID-19 患者的药物治疗和幸存者的出院后护理提出了一些共识建议。对于那些没有足够一致性来制定建议的管理方案，代表了研究重点。
