European Respiratory Review (Oct 2020)
Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020)
- Chunxue Bai,
- Sanjay H. Chotirmall,
- Jordi Rello,
- George A. Alba,
- Leo C. Ginns,
- Jerry A. Krishnan,
- Robert Rogers,
- Elisabeth Bendstrup,
- Pierre-Regis Burgel,
- James D. Chalmers,
- Abigail Chua,
- Kristina A. Crothers,
- Abhijit Duggal,
- Yeon Wook Kim,
- John G. Laffey,
- Carlos M. Luna,
- Michael S. Niederman,
- Ganesh Raghu,
- Julio A. Ramirez,
- Jordi Riera,
- Oriol Roca,
- Maximiliano Tamae-Kakazu,
- Antoni Torres,
- Richard R. Watkins,
- Miriam Barrecheguren,
- Mirko Belliato,
- Hassan A. Chami,
- Rongchang Chen,
- Gustavo A. Cortes-Puentes,
- Charles Delacruz,
- Margaret M. Hayes,
- Leo M.A. Heunks,
- Steven R. Holets,
- Catherine L. Hough,
- Sugeet Jagpal,
- Kyeongman Jeon,
- Takeshi Johkoh,
- May M. Lee,
- Janice Liebler,
- Gerry N. McElvaney,
- Ari Moskowitz,
- Richard A. Oeckler,
- Iñigo Ojanguren,
- Anthony O'Regan,
- Mathias W. Pletz,
- Chin Kook Rhee,
- Marcus J. Schultz,
- Enrico Storti,
- Charlie Strange,
- Carey C. Thomson,
- Francesca J. Torriani,
- Xun Wang,
- Wim Wuyts,
- Tao Xu,
- Dawei Yang,
- Ziqiang Zhang,
- Kevin C. Wilson
Affiliations
- Chunxue Bai
- Dept of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China
- Sanjay H. Chotirmall
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Jordi Rello
- Vall d'Hebron Research Institute, Barcelona, Spain
- George A. Alba
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Leo C. Ginns
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Jerry A. Krishnan
- Dept of Medicine, University of Illinois at Chicago, Chicago, IL, USA
- Robert Rogers
- Division of Pulmonary and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Elisabeth Bendstrup
- Center for Rare Lung Diseases, Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
- Pierre-Regis Burgel
- Dept of Respiratory Medicine, Cochin Hospital, Assistance Publique Hopîtaux de Paris, Université de Paris and Institut Cochin, Inserm U1016, Paris, France
- James D. Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
- Abigail Chua
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Internal Medicine, Stony Brook University, Stony Brook, NY, USA
- Kristina A. Crothers
- Dept of Medicine, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle WA, USA
- Abhijit Duggal
- Dept of Critical Care, Cleveland Clinic, Cleveland OH, USA
- Yeon Wook Kim
- Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- John G. Laffey
- Dept of Anesthesia and Intensive Care Medicine, Galway University Hospitals, National University of Ireland, Galway, Ireland
- Carlos M. Luna
- Dept of Medicine, Pulmonary Diseases Division, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina
- Michael S. Niederman
- Division of Pulmonary and Critical Care, Dept of Medicine, Weill Cornell Medicine, New York NY, USA
- Ganesh Raghu
- Dept of Medicine, University of Washington, Seattle WA, USA
- Julio A. Ramirez
- Division of Infectious Diseases, Dept of Medicine, University of Louisville, Louisville KY, USA
- Jordi Riera
- Vall d'Hebron Research Institute, Barcelona, Spain
- Oriol Roca
- Vall d'Hebron Research Institute, Barcelona, Spain
- Maximiliano Tamae-Kakazu
- Division of Pulmonary, Critical Care, and Sleep Medicine, Spectrum Health-Michigan State University, Grand Rapids MI, USA
- Antoni Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Richard R. Watkins
- Dept of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
- Miriam Barrecheguren
- Respiratory Dept, Vall d'Hebron University Hospital, Barcelona, Spain
- Mirko Belliato
- UOC Anestesia e Rianimazione 1, IRCCS Policlinico San Matteo, Pavia, Italy
- Hassan A. Chami
- Dept of Medicine, American University of Beirut, Beirut, Lebanon
- Rongchang Chen
- Dept of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, Shenzhen People's Hospital, First Affiliated Hospital of South University of Science and Technology of China, Shenzhen, China
- Gustavo A. Cortes-Puentes
- Dept of Pulmonary Medicine, Mayo Clinic, Rochester MN, USA
- Charles Delacruz
- Dept of Medicine, Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven CT, USA
- Margaret M. Hayes
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston MA, USA
- Leo M.A. Heunks
- Dept of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Steven R. Holets
- Dept of Pulmonary Medicine, Mayo Clinic, Rochester MN, USA
- Catherine L. Hough
- Division of Pulmonary and Critical Care, Dept of Medicine, Oregon Health Sciences University, Portland, OR, USA
- Sugeet Jagpal
- Dept of Medicine, Robert Wood Johnson University Hospital, New Brunswick NJ, USA
- Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Takeshi Johkoh
- Dept of Radiology, Kansai Rosai Hospital, Amagaski, Japan
- May M. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Internal Medicine, University of Southern California, Los Angeles CA, USA
- Janice Liebler
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Internal Medicine, University of Southern California, Los Angeles CA, USA
- Gerry N. McElvaney
- Department of Respiratory Medicine, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland
- Ari Moskowitz
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston MA, USA
- Richard A. Oeckler
- Dept of Pulmonary Medicine, Mayo Clinic, Rochester MN, USA
- Iñigo Ojanguren
- Respiratory Dept, Vall d'Hebron University Hospital, Barcelona, Spain
- Anthony O'Regan
- Dept of Respiratory Medicine, Galway University Hospitals, National University of Ireland, Galway, Ireland
- Mathias W. Pletz
- Institute of Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University, Jena, Germany
- Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Dept of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Marcus J. Schultz
- Dept of Intensive Care, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Enrico Storti
- Dept of Anesthesia and Critical Care, Ospedale Maggiore di Lodi, Lodi, Italy
- Charlie Strange
- Dept of Medicine, Medical University of South Carolina, Charleston SC, USA
- Carey C. Thomson
- Division of Pulmonary and Critical Care Medicine, Mount Auburn Hospital, Cambridge MA, Harvard Medical School, Boston MA, USA
- Francesca J. Torriani
- Infection Prevention and Clinical Epidemiology Unit at UC San Diego Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, UC San Diego, San Diego CA, USA
- Xun Wang
- Dept of Pulmonary and Critical Care Medicine, The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi, China
- Wim Wuyts
- Dept of Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Tao Xu
- Dept of Pulmonary and Critical Care Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- Dawei Yang
- Dept of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China
- Ziqiang Zhang
- Dept of Pulmonary and Critical Care Medicine, Tongji Hospital Tongji University, Shanghai, China
- Kevin C. Wilson
- Dept of Medicine, Boston University School of Medicine, Boston, MA, USA
- DOI
- https://doi.org/10.1183/16000617.0287-2020
- Journal volume & issue
-
Vol. 29,
no. 157
Abstract
Background 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. Methods 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. Results 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. Conclusions 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.
