Australian guidelines for the clinical care of people with COVID-19

Published by National COVID-19 Clinical Evidence Taskforce on Jun 10, 2021

Disclaimer

The consortium is seeking NHMRC approval of the guideline under section 14A of the National Health and Medical Research Council Act 1992. As part of the approval process (and for the lifetime of the guidelines), public consultation is required. We welcome your feedback and suggestions. Comments can be submitted via the feedback function under each recommendation in Magic or by emailing guidelines@covid19evidence.net.au.

These clinical guidelines are a general guide to appropriate practice, to be followed subject to the clinician’s judgement and the patient’s preference in each individual case. The guidelines are not intended to be proscriptive. They are designed to provide information to assist decision making and have been informed by the highest quality evidence available at the time of compilation. Accordingly, the parties involved in the development of these guidelines shall have no liability to any users of the information contained in this publication for any loss or damage, cost or expense incurred or arising from reliance on the information contained in this publication.   
 

Sponsors

Development of the Australian guidelines for the clinical care of people with COVID-19 is funded by the Australian Government Department of Health, Victorian Government Department of Health and Human Services, the Ian Potter Foundation and the Walter Cottman Endowment Fund, managed by Equity Trustees

Contact

Abstract

Language

en

PICOS

PICO 1.1

Population
Patients with COVID-19
Intervention
Baricitinib
Comparator
Standard care
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
Corticosteroids
Comparator
Standard care
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
Remdesivir
Comparator
Standard care
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
Tocilizumab
Comparator
Standard care
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
C21
Comparator
Placebo
Outcomes

PICO 1.1

Population
Healthcare workers (with no active or prior COVID-19)
Intervention
Pre-exposure hydroxychloroquine
Comparator
Placebo
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
High-flow nasal oxygen therapy
Comparator
Conventional oxygen therapy
Outcomes

PICO 1.1

Population
Patients with COVID-19 on supplementary oxygen who are not yet intubated
Intervention
Prone positioning
Comparator
No prone positioning
Outcomes

PICO 1.1

Population
Patients with COVID-19
Intervention
ECMO
Comparator
No ECMO
Outcomes

PICO 1.1

Population
Patients with severe COVID-19
Intervention
Therapeutic dose thromboprophylaxis
Comparator
Prophylactic dose thromboprophylaxis
Outcomes

PICO 1.1

Population
People with COVID-19 who are taking ACEIs/ARBs
Intervention
Continued use of concomitant ACEIs/ARBs
Comparator
Stopping concomitant ACEIs/ARBs
Outcomes

PICO 1.1

Population
Children and adolescents with COVID-19
Intervention
Intravenous immunoglobulin plus methylprednisolone
Comparator
Intravenous immunoglobulin
Outcomes

PICO 1.2

Population
Patients with COVID-19 who do not require oxygen
Intervention
Corticosteroids
Comparator
Standard Care
Outcomes

PICO 1.2

Population
Remdesivir dosage for COVID-19
Intervention
5 days' treatment
Comparator
Up to 10 days' treatment
Outcomes

PICO 1.2

Population
Patients with COVID-19
Intervention
High-flow nasal oxygen therapy
Comparator
Conventional oxygen therapy
Outcomes

PICO 1.2

Population
Patients with COVID-19
Intervention
DO NOT USE [COPPO] Proning
Comparator
Not proning
Outcomes

PICO 1.2

Population
People with moderate COVID-19
Intervention
VTE prophylaxis
Comparator
Standard care
Outcomes

PICO 1.3

Population
Children and adolescents with COVID-19
Intervention
High-flow nasal oxygen therapy
Comparator
Conventional oxygen therapy
Outcomes

PICO 1.3

Population
Patients with severe or critical COVID-19
Intervention
Increased-dose thromboprophylaxis
Comparator
Conventional treatment
Outcomes

PICO 1.4

Population
Patients with severe or critical COVID-19
Intervention
Therapeutic anticoagulation
Comparator
Prophylactic anticoagulation (standard or intermediate)
Outcomes

PICO 1.5

Population
Moderate patients
Intervention
Therapeutic anticoagulation
Comparator
Prophylactic anticoagulation
Outcomes

PICO 2.1

Population
Special populations with COVID-19 [adapted from general adult population]
Intervention
Corticosteroids
Comparator
Standard care
Outcomes

PICO 2.1

Population
Patients with COVID-19
Intervention
Anakinra
Comparator
Standard care
Outcomes

PICO 2.1

Population
People exposed to COVID-19
Intervention
Hydroxychloroquine post-exposure prophylaxis
Comparator
Placebo
Outcomes

PICO 2.1

Population
Patients with hypoxaemia associated with COVID-19
Intervention
Non-invasive ventilation (helmet or face mask)
Comparator
High-flow nasal oxygen (HFNO) or supplementary oxygen therapy (SOT)
Outcomes

PICO 2.1

Population
Pregnant women with COVID-19
Intervention
(V-V) ECMO
Comparator
Mechanical ventilation or other rescue therapies
Outcomes

PICO 2.1

Population
Pregnant women with COVID-19
Intervention
Caesarean section
Comparator
Vaginal birth
Outcomes

PICO 2.1

Population
Patients with COVID-19
Intervention
Sotrovimab
Comparator
Placebo
Outcomes

PICO 2.2

Population
Pregnant women with COVID-19 who do not require oxygen [adapted from general adult population]
Intervention
Corticosteroids
Comparator
Standard care
Outcomes

PICO 2.2

Population
Special populations
Intervention
Hydroxychloroquine post-exposure prophylaxis
Comparator
Placebo
Outcomes

PICO 2.2

Population
Patients with hypoxaemia associated with COVID-19
Intervention
Non-invasive ventilation (helmet or face mask)
Comparator
High-flow nasal oxygen (HFNO) or supplementary oxygen therapy (SOT)
Outcomes

PICO 2.3

Population
Children and adolescents with hypoxaemia associated with COVID-19
Intervention
Non-invasive ventilation (helmet or face mask)
Comparator
High-flow nasal oxygen (HFNO) or supplementary oxygen therapy (SOT)
Outcomes

PICO 3.1

Population
EXEMPLAR evidence summary
Intervention
Comparator
Outcomes

PICO 3.1

Population
Children or adolescents with COVID-19 who do not require oxygen [adapted from general adult population]
Intervention
Corticosteroids
Comparator
Standard care
Outcomes

PICO 3.1

Population
Children and adolescents, pregnant or breastfeeding women, with COVID-19
Intervention
Tocilizumab
Comparator
Standard care
Outcomes

PICO 3.1

Population
Patients with COVID-19
Intervention
Aprepitant
Comparator
Standard care
Outcomes

PICO 3.1

Population
People with asthma or COPD and COVID-19
Intervention
Corticosteroids
Comparator
Standard care
Outcomes

PICO 3.1

Population
Pregnant women with COVID-19
Intervention
Delayed cord clamping
Comparator
Outcomes

PICO 3.2

Population
Special populations with COVID-19
Intervention
Aprepitant
Comparator
Standard care
Outcomes

PICO 4.1

Population
Patients with COVID-19
Intervention
Sarilumab
Comparator
Standard care
Outcomes

PICO 4.1

Population
Patients with COVID-19
Intervention
Baloxavir marboxil
Comparator
Standard care
Outcomes

PICO 4.1

Population
Patients requiring emergency intubation
Intervention
Videolaryngoscopy
Comparator
Direct laryngoscopy
Outcomes

PICO 4.1

Population
Mechanically ventilated children and adolescents with COVID-19 and persistent ventilator dyssynchrony, the need for ongoing deep sedation, prone ventilation or persistently high plateau pressures
Intervention
Continuous infusion of NMBA
Comparator
No continuous infusion of NMBA
Outcomes

PICO 4.1

Population
Women with COVID-19 who have given birth
Intervention
Skin-to-skin contact
Comparator
No skin-to-skin contact
Outcomes

PICO 4.2

Population
Special populations with COVID-19
Intervention
Baloxavir marboxil
Comparator
Standard care
Outcomes

PICO 4.2

Population
Neonates, children and adolescents requiring emergency intubation
Intervention
Videolaryngoscopy
Comparator
Direct laryngoscopy
Outcomes

PICO 5.1

Population
Bamlanivimab for COVID-19
Intervention
Bamlanivimab
Comparator
Standard care
Outcomes

PICO 5.1

Population
Mechanically ventilated adults with COVID-19 and persistent ventilator dyssynchrony, the need for ongoing deep sedation, prone ventilation or persistently high plateau pressures
Intervention
Continuous infusion of NMBA
Comparator
No continuous infusion of NMBA
Outcomes

PICO 5.1

Population
Newborns of mothers with confirmed COVID-19
Intervention
Breastfeeding or breast milk
Comparator
No breastfeeding or breast milk
Outcomes

PICO 6.1

Population
Patients with COVID-19
Intervention
Azithromycin
Comparator
Standard care
Outcomes

PICO 6.1

Population
Patients with COVID-19
Intervention
Bamlanivimab plus etesevimab
Comparator
Placebo
Outcomes

PICO 6.1

Population
Women with COVID-19 who have given birth
Intervention
Rooming-in
Comparator
No rooming-in
Outcomes

PICO 7.1

Population
Colchicine for COVID-19
Intervention
Colchicine
Comparator
Standard care
Outcomes

PICO 7.1

Population
Patients with COVID-19
Intervention
Bromhexine hydrochloride
Comparator
Standard care
Outcomes

PICO 8.1

Population
Patients with COVID-19
Intervention
Convalescent plasma
Comparator
Control
Outcomes

PICO 8.1

Population
Patients with COVID-19
Intervention
Budesonide
Comparator
Standard care
Outcomes

PICO 8.2

Population
NEW Patients with COVID-19
Intervention
Budesonide
Comparator
Standard care
Outcomes

PICO 9.1

Population
Patients with COVID-19
Intervention
Hydroxychloroquine
Comparator
Standard care
Outcomes

PICO 9.1

Population
Patients with COVID-19
Intervention
Camostat mesilate
Comparator
Placebo
Outcomes

PICO 10.1

Population
Patients with COVID-19
Intervention
Hydroxychloroquine plus azithromycin
Comparator
Standard care
Outcomes

PICO 10.1

Population
Patients with COVID-19
Intervention
Chloroquine
Comparator
Standard care
Outcomes

PICO 10.2

Population
Special populations with COVID-19
Intervention
Chloroquine
Comparator
Standard care
Outcomes

PICO 11.1

Population
Patients with COVID-19
Intervention
Interferon β-1a
Comparator
Standard care
Outcomes

PICO 11.1

Population
Patients with COVID-19
Intervention
Combined metabolic cofactor supplementation
Comparator
Control
Outcomes

PICO 12.1

Population
Patients with COVID-19
Intervention
Interferon β-1a plus lopinavir-ritonavir
Comparator
Standard care
Outcomes

PICO 12.1

Population
Patients with COVID-19
Intervention
CT-P59 monoclonal antibody
Comparator
Standard care
Outcomes

PICO 12.1

Population
People with a diagnosis of SARS-CoV-2 infection
Intervention
Surgery
Comparator
No surgery
Outcomes

PICO 13.1

Population
Patients with COVID-19
Intervention
Lopinavir-ritonavir
Comparator
Standard care
Outcomes

PICO 13.1

Population
Darunavir-cobicistat for COVID-19
Intervention
Darunavir-cobicistat
Comparator
Standard care
Outcomes

PICO 13.2

Population
Special populations with COVID-19
Intervention
Darunavir-cobicistat
Comparator
Standard care
Outcomes

PICO 14.1

Population
Patients with COVID-19
Intervention
Dutasteride
Comparator
Standard Care
Outcomes

PICO 15.1

Population
Patients with COVID-19
Intervention
Enisamium
Comparator
Placebo
Outcomes

PICO 16.1

Population
Patients with COVID-19
Intervention
Favipiravir
Comparator
Standard care
Outcomes

PICO 17.1

Population
Fluvoxamine for COVID-19
Intervention
Fluvoxamine
Comparator
Placebo
Outcomes

PICO 18.1

Population
Patients with COVID-19
Intervention
Human umbilical cord mesenchymal stem cells (hUC-MSC)
Comparator
Standard care
Outcomes

PICO 19.1

Population
Patients with COVID-19
Intervention
Inhaled interferon β-1a
Comparator
Standard care
Outcomes

PICO 20.1

Population
Patients with COVID-19
Intervention
Interferon β-1b
Comparator
Standard care
Outcomes

PICO 20.2

Population
Special populations with COVID-19
Intervention
Interferon β-1b
Comparator
Standard care
Outcomes

PICO 21.1

Population
Patients with COVID-19
Intervention
Interferon gamma
Comparator
Standard care
Outcomes

PICO 21.2

Population
Special populations with COVID-19
Intervention
Interferon gamma
Comparator
Standard care
Outcomes

PICO 22.1

Population
Patients with COVID-19
Intervention
IFN-κ plus TFF2
Comparator
Standard care
Outcomes

PICO 23.1

Population
Patients with COVID-19
Intervention
Immunoglobulin
Comparator
Placebo
Outcomes

PICO 24.1

Population
Patients with COVID-19
Intervention
Immunoglobulin plus methylprednisolone
Comparator
Standard care
Outcomes

PICO 24.2

Population
Special populations with COVID-19
Intervention
Immunoglobulin plus methylprednisolone
Comparator
Standard care
Outcomes

PICO 25.1

Population
Patients with COVID-19
Intervention
Ivermectin
Comparator
Standard care
Outcomes

PICO 25.2

Population
NEW Patients with COVID-19
Intervention
Ivermectin
Comparator
Standard care
Outcomes

PICO 26.1

Population
Patients with COVID-19
Intervention
Ivermectin plus doxycycline
Comparator
Standard care
Outcomes

PICO 27.1

Population
Patients with COVID-19
Intervention
Lenzilumab
Comparator
Placebo
Outcomes

PICO 28.1

Population
Patients with COVID-19
Intervention
N-acetylcysteine
Comparator
Placebo
Outcomes

PICO 29.1

Population
Patients with COVID-19
Intervention
Nitazoxanide
Comparator
Standard care
Outcomes

PICO 30.1

Population
Patients with COVID-19
Intervention
Peginterferon lambda
Comparator
Standard care
Outcomes

PICO 31.1

Population
Patients with COVID-19
Intervention
rhG-CSF
Comparator
Standard care
Outcomes

PICO 31.2

Population
Special populations with COVID-19
Intervention
rhG-CSF
Comparator
Standard care
Outcomes

PICO 32.1

Population
Patients with COVID-19
Intervention
REGN-COV2
Comparator
Placebo
Outcomes

PICO 32.2

Population
NEW Patients with COVID-19
Intervention
REGN-COV2
Comparator
Placebo
Outcomes

PICO 33.1

Population
Patients with COVID-19
Intervention
Ruxolitinib
Comparator
Placebo
Outcomes

PICO 33.2

Population
Special populations with COVID-19
Intervention
Ruxolitinib
Comparator
Placebo
Outcomes

PICO 34.1

Population
Patients with COVID-19
Intervention
Sofosbuvir-daclatasvir
Comparator
Standard care
Outcomes

PICO 35.1

Population
Sulodexide for COVID-19
Intervention
Sulodexide
Comparator
Placebo
Outcomes

PICO 36.1

Population
Patients with COVID-19
Intervention
Telmisartan
Comparator
Standard care
Outcomes

PICO 36.2

Population
Special populations with COVID-19
Intervention
Telmisartan
Comparator
Standard care
Outcomes

PICO 37.1

Population
Patients with COVID-19
Intervention
Triazavirin
Comparator
Placebo
Outcomes

PICO 38.1

Population
Patients with COVID-19
Intervention
Umifenovir
Comparator
Standard care
Outcomes

PICO 39.1

Population
Patients with COVID-19
Intervention
Vitamin C
Comparator
Standard care
Outcomes

PICO 40.1

Population
Patients with COVID-19
Intervention
Vitamin D analogues
Comparator
Standard care
Outcomes

PICO 41.1

Population
Patients with COVID-19
Intervention
Zinc
Comparator
Standard care
Outcomes

PICO 41.2

Population
N95/P2 versus Sx mask for Prevent SARS-CoV-2 transmission
Intervention
Headache incidence
Comparator
Outcomes