National Institutes of Health Panel Issues New Guidelines

A National Institutes of Health panel has released new guidelines on treating patients with COVID-19. Here are some of the highlights:

  • The panel does not recommend any drug for pre- or post-exposure prophylaxis outside of clinical trials.
  • It does not make a recommendation for specific antiviral or immunomodulatory treatments, as no drug has been proven to be safe and effective. The panel does provide rationale for use of certain therapies under investigation, as well as a summary of studies on these treatments.
  • It comes out against use of hydroxychloroquine plus azithromycin outside of clinical trials because of the toxicity risk, as well as against lopinavir/ritonavir or other HIV protease inhibitors because of negative clinical trial results and unfavorable pharmacodynamics. The panel also recommends against interferons and Janus kinase inhibitors.
  • The group recommends against use of systemic corticosteroids for mechanically ventilated adults with COVID-19 who don’t have acute respiratory distress syndrome (ARDS).
  • It prefers low-dose corticosteroids over no corticosteroids in patients with refractory shock.

The full text of the guidelines, with additional recommendations, is available at https://covid19treatmentguidelines.nih.gov/.

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