Anesi George L, Degnan Kathleen, Dutcher Lauren, Saw Stephen, Maguire Christina, Binkley Amanda, Patel Sonal, Athans Vasilios, Barton Todd D, Binkley Shawn, Candeloro Christina L, Herman David J, Kasbekar Nishaminy, Kennedy Leigh, Millstein Jeffrey H, Meyer Nuala J, Talati Naasha J, Patel Hinal, Pegues David A, Sayre Patrick J, Tebas Pablo, Terico Adrienne T, Murphy Kathleen M, O'Donnell Judith A, White Melissa, Hamilton Keith W
Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Open Forum Infect Dis. 2023 Aug 9;10(8):ofad428. doi: 10.1093/ofid/ofad428. eCollection 2023 Aug.
The Penn Medicine COVID-19 Therapeutics Committee-an interspecialty, clinician-pharmacist, and specialist-front line primary care collaboration-has served as a forum for rapid evidence review and the production of dynamic practice recommendations during the 3-year coronavirus disease 2019 public health emergency. We describe the process by which the committee went about its work and how it navigated specific challenging scenarios. Our target audiences are clinicians, hospital leaders, public health officials, and researchers invested in preparedness for inevitable future threats. Our objectives are to discuss the logistics and challenges of forming an effective committee, undertaking a rapid evidence review process, aligning evidence-based guidelines with operational realities, and iteratively revising recommendations in response to changing pandemic data. We specifically discuss the arc of evidence for corticosteroids; the noble beginnings and dangerous misinformation end of hydroxychloroquine and ivermectin; monoclonal antibodies and emerging viral variants; and patient screening and safety processes for tocilizumab, baricitinib, and nirmatrelvir-ritonavir.
宾夕法尼亚大学医学部新冠治疗委员会——一个跨专业、临床医生与药剂师以及专科医生与一线初级保健医生的合作组织——在2019年冠状病毒病3年公共卫生紧急事件期间，充当了快速证据审查和制定动态实践建议的论坛。我们描述了该委员会开展工作的过程以及应对特定具有挑战性情况的方式。我们的目标受众是临床医生、医院领导、公共卫生官员以及致力于为未来不可避免的威胁做好准备的研究人员。我们的目标是讨论组建一个有效委员会的后勤工作和挑战、开展快速证据审查过程、使基于证据的指南与实际操作相匹配，以及根据不断变化的疫情数据反复修订建议。我们特别讨论了皮质类固醇的证据演变；羟氯喹和伊维菌素的良好开端与危险的错误信息结局；单克隆抗体和新兴病毒变体；以及托珠单抗、巴瑞替尼和奈玛特韦-利托那韦的患者筛查和安全流程。
