COVID-19 Therapies for inpatients: a review and quality assessment of clinical guidelines

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  • Wohl, David A.
    • Affiliation: Gillings School of Global Public Health
  • Espinueva, Aprille A.
    • Other Affiliation: Gilead Sciences Inc.
  • Dau, Lauren
    • Other Affiliation: Gilead Sciences Inc.
  • Wang, Chen-Yu
    • Other Affiliation: Gilead Sciences Inc.
  • Lachmann, Alexandra
    • Other Affiliation: Gilead Sciences Inc.
  • Bam, Rujuta A.
    • Other Affiliation: Gilead Sciences Inc.
  • Rawal, Aaditya
    • Other Affiliation: Costello Medical
  • Chappell-Smith, Kerris
    • Other Affiliation: Costello Medical
  • Rockstroh, Juergen K.
    • Other Affiliation: University Hospital Bonn
Abstract
  • Due to condensed development processes, expanding evidence and differences in healthcare system characteristics, many COVID-19 guidelines differ in their quality and treatment recommendations, which has consequences for clinical practice. This review aimed to identify COVID-19 treatment guidelines, assess their quality, and summarise their recommendations. Guidelines were identified for five therapies most commonly used among inpatients with COVID-19 (remdesivir, dexamethasone, tocilizumab, baricitinib, and casirivimab/imdevimab) from 11 countries. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. Full details of recommendations and supporting evidence were analysed for high-quality guidelines, defined as those scoring ≥50% in Domain 3 (Rigour of Development) of AGREE-II. Overall, guidelines differed substantially in their quality and, even among high-quality guidelines using the same evidence, recommendations regarding specific therapeutics varied. Potential reasons for this heterogeneity, including the availability and consistency of clinical data, visibility of trial endpoints, and context-specific factors, are discussed.
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  • Article
Rights statement
  • In Copyright
License
  • Attribution-NonCommercial 4.0 International
Journal title
  • ERJ Open Research
Page start
  • 00236-2022
Language
  • English
Version
  • Postprint
ISSN
  • 2312-0541

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