The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia - Critical Care Science (CCS)
Home » Articles » The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia
The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia
To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil.
Methods:
Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method.
Results:
Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made.
Conclusion:
New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.
Falavigna M, Araujo CLP, Barbosa AN, Belli KC, Colpani V, Dal-Pizzol F, Silva RM, et al. The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia. Crit Care Sci 2023;35(3):243-55.
Electronic Document Format (ABNT)
Falavigna, Maicon; Araujo, Cintia Laura Pereira de; Barbosa, Alexandre Naime; Belli, Karlyse Claudino; Colpani, Verônica; Dal-Pizzol, Felipe; Silva, Rosemeri Maurici da; Azevedo, Luciano César Pontes de; Dias, Maria Beatriz Souza; Amaral, José Luiz Gomes do; Dorneles, Gilson Pires; Ferreira, Juliana Carvalho; Freitas, Ana Paula da Rocha; Gräf, Débora Dalmas; Guimarães, Hélio Penna; Lobo, Suzana Margareth Ajeje; Machado, Flávia Ribeiro; Nunes, Michelle Silva; Oliveira, Maura Salaroli de; Parahiba, Suena Medeiros; Rosa, Regis Goulart; Santos, Vania Cristina Canuto; Sobreira, Marcone Lima; Veiga, Viviane Cordeiro; Xavier, Ricardo Machado; Zavascki, Alexandre Prehn; Stein, Cinara; Carvalho, Carlos Roberto Ribeiro de. The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia. Crit Care Sci, v. 35, n. 3, p. 243-255, Dec. 2023.
Electronic Document Format (APA)
Falavigna, M., Araujo, C. L. P. , Barbosa, A. N., Belli, K. C., Colpani, V., Dal-Pizzol, F., Silva, R. M. , Azevedo, L. C. P. , Dias, M. B. S., Amaral, J. L. G. , Dorneles, G. P., Ferreira, J. C., Freitas, A. P. R., Gräf, D. D., Guimarães, H. P., Lobo, S. M. A., Machado, F. R., Nunes, M. S., Oliveira, M. S. , Parahiba, S. M., Rosa, R. G., Santos, V. C. C., Sobreira, M. L., Veiga, V. C., Xavier, R. M., Zavascki, A. P., Stein, C., & Carvalho, C. R. R. (2023). The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia. Crit Care Sci, 35(3), 243-255.
Electronic Document Format (ISO)
Falavigna, Maicon and Araujo, Cintia Laura Pereira de and Barbosa, Alexandre Naime and Belli, Karlyse Claudino and Colpani, Verônica and Dal-Pizzol, Felipe and Silva, Rosemeri Maurici da and Azevedo, Luciano César Pontes de and Dias, Maria Beatriz Souza and Amaral, José Luiz Gomes do and Dorneles, Gilson Pires and Ferreira, Juliana Carvalho and Freitas, Ana Paula da Rocha and Gräf, Débora Dalmas and Guimarães, Hélio Penna and Lobo, Suzana Margareth Ajeje and Machado, Flávia Ribeiro and Nunes, Michelle Silva and Oliveira, Maura Salaroli de and Parahiba, Suena Medeiros and Rosa, Regis Goulart and Santos, Vania Cristina Canuto and Sobreira, Marcone Lima and Veiga, Viviane Cordeiro and Xavier, Ricardo Machado and Zavascki, Alexandre Prehn and Stein, Cinara and Carvalho, Carlos Roberto Ribeiro de. The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia. Crit Care Sci [online]. 2023, vol. 35, n. 3, [cited 2024-05-08], pp.243-255. Available from: <https://criticalcarescience.org/article/the-ii-brazilian-guidelines-for-the-pharmacological-treatment-of-patients-hospitalized-with-covid-19-joint-guidelines-of-the-associacao-brasileira-de-medicina-de-emergencia-associacao-de-medicina-int/>.
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Figure 1 | Recommendations for the pharmacological treatment of patients hospitalized with COVID-19.
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