Therapeutic strategies for severe COVID-19: a position paper from the Italian Society of Infectious and Tropical Diseases (SIMIT)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, wi...

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Published in:Clinical microbiology and infection Vol. 27; no. 3; p. 389
Main Authors: Mussini, Cristina, Falcone, Marco, Nozza, Silvia, Sagnelli, Caterina, Parrella, Roberto, Meschiari, Marianna, Petrosillo, Nicola, Mastroianni, Claudio, Cascio, Antonio, Iaria, Chiara, Galli, Massimo, Chirianni, Antonio, Sagnelli, Evangelista, Iacobello, Carmelo, Di Perri, Giovanni, Mazzotta, Francesco, Carosi, Giampiero, Tinelli, Marco, Grossi, Paolo, Armignacco, Orlando, Portelli, Vincenzo, Andreoni, Massimo, Tavio, Marcello
Format: Journal Article
Language:English
Published: England 01.03.2021
Subjects:
COVID-19 - diagnosis
COVID-19 - drug therapy
COVID-19 - epidemiology
COVID-19 - therapy
Humans
Italy - epidemiology
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
SARS-CoV-2 - isolation & purification
Societies, Medical - standards
Standard of Care
Italy
COVID-19
Therapy
Pneumonia
SARS-CoV-2
Coronavirus
ISSN:1469-0691, 1469-0691
Online Access:Get more information
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Summary:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, with conflicting results, has led to rapid changes in treatment guidelines. Our aim was to narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and interpretation of the data by experts who are treating patients in the frontline setting. The panel conducted a detailed review of the literature and eventual press releases from randomized clinical trials for each possible available treatment. Inductive PubMed search waws performed for publications relevant to the topic, including all clinical trials conducted. The result was a flowchart with treatment indications for patients with COVID-19. After 6 months of a pandemic situation and before a possible second coronavirus wave descends on Europe, it is important to evaluate which drugs proved to be effective while also considering that results from many randomized clinical trials are still awaited. Indeed, among treatments for COVID-19, only glucocorticoids have resulted in an association with a significant decrease in mortality in published randomized controlled trials. New therapeutic strategies are urgently needed.
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ISSN:1469-0691
1469-0691
DOI:10.1016/j.cmi.2020.12.011