COVID-19 Evidenzsynthesen und Leitlinienempfehlungen

Published by AWMF/CEO-sys Koordinierende on Sep 26, 2022

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Abstract

Evidenzbasierte Handlungsempfehlungen zu diagnostischen und therapeutischen sowie Public Health Fragestellungen zu COVID-19 ambulant und stationär

Language

de

PICOS

PICO 20.1

Population
Hospitalised patients with moderate/critical COVID-19 infection (according to WHO clinical progression score 4-6)
Intervention
Vitamin D supplementation
Comparator
Standard of Care or Placebo
Outcomes

PICO 20.2

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
Ivermectin (plus standard of care)
Comparator
Placebo or standard of care
Outcomes

PICO 20.3

Population
All adult patients (with or without risk factors for COVID-19) with positive PCR test for SARS-CoV-2 and anosmia
Intervention
topical corticosteroid
Comparator
placebo or standard care
Outcomes

PICO 20.4

Population
All adult patients (with or without risk factors for COVID-19) with positive PCR test for SARS-CoV-2
Intervention
inhaled corticosteroid
Comparator
standard care
Outcomes

PICO 20.5

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
Antiplatelet agents
Comparator
Placebo
Outcomes

PICO 20.6

Population
Stand November 2021: Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
bamlanivimab
Comparator
placebo
Outcomes

PICO 20.7

Population
Stand November 2021: Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
bamlanivimab and etesevimab
Comparator
placebo
Outcomes

PICO 20.8

Population
Stand November 2021: Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
casirivimab and imdevimab
Comparator
placebo
Outcomes

PICO 20.9

Population
NEW preprint: Adult in-hospital patients not hospitalised due to COVID-19
Intervention
regdanvimab
Comparator
placebo
Outcomes

PICO 20.10

Population
Casirivimab/imdevimab in healthy, unvaccinated people; prevention
Intervention
casirivimab and imdevimab
Comparator
placebo
Outcomes

PICO 20.11

Population
Bamlanivimab in healthy, unvaccinated people; prevention
Intervention
bamlanivimab 4.2 g
Comparator
placebo
Outcomes

PICO 20.12

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
Azithromycin (plus standard of care)
Comparator
Placebo or standard of care
Outcomes

PICO 20.13

Population
People with SARS-CoV-2 infection and asymptomatic or mild disease
Intervention
Colchicine
Comparator
Placebo or standard care alone
Outcomes

PICO 20.14

Population
Adults living in the community with SARS CoV- 2 infection confirmed by polymerase chain reaction assay and who were symptomatic
Intervention
Fluvoxamine
Comparator
Placebo
Outcomes

PICO 20.15

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild disease
Intervention
Thromboprophylaxis (standard dose)
Comparator
Placebo
Outcomes

PICO 20.16

Population
All adult patients (with or without risk factors for COVID-19) with positive PCR test for SARS-CoV-2
Intervention
inhaled corticosteroid (plus standard care)
Comparator
standard care (plus/minus placebo)
Outcomes

PICO 20.17

Population
Adult outpatients with confirmed COVID-19 (PCR or antigen), at least one risk factor
Intervention
sotrovimab, 500 mg
Comparator
placebo
Outcomes

PICO 20.18

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild to moderate disease (not WHO classification!)
Intervention
molnupiravir plus standard of care
Comparator
standard care (plus/minus placebo)
Outcomes

PICO 20.19

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild disease (>= 12 years, with risk factor, or >= 60 years)otr0
Intervention
Remdesivir
Comparator
placebo
Outcomes

PICO 30.1

Population
All adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Treatment with Remdesivir
Comparator
Standard of Care
Outcomes

PICO 30.2

Population
Hospitalised patients with confirmed SARS-CoV-2 infection
Intervention
Convalescent plasma
Comparator
Standard of Care or Placebo
Outcomes

PICO 30.3

Population
Patients with severe/critical COVID-19 (WHO Kategorie: Severe Disease)
Intervention
Noninvasive Mechanical Ventilation
Comparator
Early Invasive Ventilation Mechanical Ventilation (without preceding Noninvasive Mechanical Ventilation attempts)
Outcomes

PICO 30.4

Population
Patients with severe/critical COVID-19 (WHO Kategorie: Severe Disease)
Intervention
Noninvasive Mechanical Ventilation
Comparator
Early Invasive Ventilation Mechanical Ventilation (without preceding Noninvasive Mechanical Ventilation attempts)
Outcomes

PICO 30.5

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate to severe disease, according to the WHO clinical progression scale (WHO 4 to 9)
Intervention
Therapeutic anticoagulation
Comparator
Standard of care (prophylactic anticoagulation)
Outcomes

PICO 30.6

Population
Hospitalised patients with moderate/critical COVID-19 infection (according to WHO clinical progression score 4-6)
Intervention
Vitamin D supplementation
Comparator
Standard of Care or Placebo
Outcomes

PICO 30.7

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate to severe disease, according to the WHO clinical progression scale (= WHO scale 4 to 9)
Intervention
Azithromycin (plus standard of care)
Comparator
Placebo or standard of care
Outcomes

PICO 30.8

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate disease, according to the WHO clinical progression scale (= WHO scale 4 to 5)
Intervention
Ivermectin (plus standard of care)
Comparator
Placebo or standard of care
Outcomes

PICO 30.9

Population
All adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Tocilizumab+Standard of Care
Comparator
Standard of Care(+Placebo)
Outcomes

PICO 30.10

Population
Patients with a confirmed diagnosis of COVID-19 receiving interventions for palliative symptom control, with no age, gender or ethnicity restrictions
Intervention
Multi-modal pharmacological interventions for palliative symptom control (including bit not limited to opioids, antiemetics, antimuscarinics, and benzodiazepines)
Comparator
N/A
Outcomes

PICO 30.11

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate to severe disease, according to the WHO clinical progression scale (WHO 5 to 9)
Intervention
Intermediate Dose Anticoagulation
Comparator
Standard of Care (prophylactic anticoagulant)
Outcomes

PICO 30.12

Population
Critically ill adult patients with confirmed SARS-CoV-2 infection
Intervention
Concepts of early tracheotomy
Comparator
Concepts of late tracheotomy
Outcomes

PICO 30.13

Population
Adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Bamlanivimab plus standard of care
Comparator
Placebo plus standard of care
Outcomes

PICO 30.14

Population
All adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Casirivimab and imdevimab plus usual care
Comparator
Usual care only
Outcomes

PICO 30.15

Population
Seronegative adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Casirivimab and imdevimab plus usual care
Comparator
Usual care only
Outcomes

PICO 30.16

Population
Individuals with a diagnosis of COVID-19 and moderate to severe disease
Intervention
Colchicine with standard care
Comparator
Standard care with or without placebo
Outcomes

PICO 30.17

Population
Systemic corticosteroids for the treatment of COVID-19
Intervention
Systemic corticosteroids plus standard care
Comparator
standard care (plus/minus placebo)
Outcomes

PICO 30.18

Population
Systemic corticosteroids for the treatment of COVID-19
Intervention
Methylprednisolone
Comparator
Dexamethasone
Outcomes

PICO 30.19

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with severe disease, according to the WHO clinical progression scale (WHO 6)
Intervention
Awake prone positioning
Comparator
Standard of care
Outcomes

PICO 30.20

Population
Hospitalised patients with confirmed SARS-CoV-2 infection
Intervention
Janus Kinase inhibitors
Comparator
standard care alone (plus/minus placebo)
Outcomes

PICO 30.21

Population
Adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Sotrovimab, 500 mg plus standard of care
Comparator
Placebo plus standard of care
Outcomes

PICO 30.22

Population
Adult outpatients with confirmed COVID-19 (PCR or antigen), at least one risk factor
Intervention
sotrovimab, 500 mg
Comparator
placebo
Outcomes

PICO 30.23

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate to severe disease, according to the WHO clinical progression scale (WHO 4 to 9)
Intervention
Intermediate Dose Anticoagulation
Comparator
Standard of Care (prophylactic anticoagulant)
Outcomes

PICO 30.24

Population
Hospitalised patients with confirmed SARS-CoV-2 infection and with moderate to severe disease, according to the WHO clinical progression scale (WHO 4 to 9)
Intervention
Therapeutic anticoagulation
Comparator
Standard of care (prophylactic anticoagulation)
Outcomes

PICO 30.25

Population
NEW Post-discharge adults after hospitalization for COVID-19
Intervention
Low Dose Anticoagulation
Comparator
Standard of Care (no anticoagulation)
Outcomes

PICO 30.26

Population
NEW Hospitalised individuals with a confirmed or suspected diagnosis of symptomatic COVID-19
Intervention
Systemic corticosteroids plus standard care
Comparator
standard care (plus/minus placebo)
Outcomes

PICO 30.27

Population
NEW Hospitalised individuals with a confirmed diagnosis of symptomatic COVID-19
Intervention
Methylprednisolone
Comparator
Dexamethasone
Outcomes

PICO 30.28

Population
NEW Hospitalised individuals with a confirmed diagnosis of symptomatic COVID-19
Intervention
High-dose dexamethasone (12mg or higher)
Comparator
Low-dose dexamethasone (6-8mg)
Outcomes

PICO 30.29

Population
Molnupiravir for COVID-19 (inpatients)
Intervention
Molnupiravir + SOC
Comparator
SOC + placebo
Outcomes

PICO 30.30

Population
Ambulatory managed individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild to moderate disease (not WHO classification!)
Intervention
molnupiravir plus standard of care
Comparator
standard care (plus/minus placebo)
Outcomes

PICO 30.31

Population
Adults living in the community with SARS CoV- 2 infection confirmed by polymerase chain reaction assay and who were symptomatic
Intervention
Fluvoxamine
Comparator
Placebo
Outcomes

PICO 30.32

Population
NEW Anakinra for the treatment of COVID-19
Intervention
Anakinra
Comparator
standard care with or without placebo or no treatment
Outcomes

PICO 30.33

Population
NEW All adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Treatment with Remdesivir
Comparator
Standard of Care
Outcomes

PICO 30.34

Population
All adult in-hospital patients with confirmed SARS-CoV-2 infection
Intervention
Baricitinib
Comparator
standard care alone (plus/minus placebo)
Outcomes

PICO 30.35

Population
Ambulatory managed high-risk individuals with a confirmed diagnosis of SARS-CoV-2 infection
Intervention
nirmatrelvir/ritonavir
Comparator
placebo
Outcomes

PICO 30.36

Population
Anakinra for for the treatment of COVID-19
Intervention
Anakinra
Comparator
Standard of Care or Placebo
Outcomes

PICO 60.1

Population
Healthcare workers (eg, physicians, nurses); adults (≥18 years); irrespective of sex, health status, or country; diverse settings of study conduction eligible (eg, clinical setting, outpatient setting)
Intervention
Exposure to COVID-19 pandemic (ie, survey period after the first officially registered SARS-CoV-2 case in the respective country based on national infection dates published by the World Health Organization); irrespective of medical care for COVID-19 patients (ie, level of contact)
Comparator
No exposure to COVID-19 pandemic (ie, before first officially registered SARS-CoV-2 case in the respective country based on national infection dates published by the WHO)
Outcomes

PICO 60.2

Population
Healthcare workers (eg, physicians, nurses); adults (≥18 years); irrespective of sex, health status, or country; diverse settings of study conduction eligible (eg, clinical setting, outpatient setting)
Intervention
Intervention conducted in anticipation of, during, or in the aftermath of SARS-CoV 2 pandemic outbreak or its related stressors (e.g. deloyment to COVID-10 hospital or hospital ward): psychological and non-psychological (eg, pharmacological, exercise), intervention intended to foster mental health and psychosocial support, resilience (or related constructs; eg, hardiness, posttraumatic growth, psychological adjustment) and/or stress management; focus on improving the participants’ ability to cope with the various stressors of a pandemic (eg, symptoms and death, quarantine); any setting (eg, individual or group setting); any delivery format (eg, face-to-face or online); irrespective of content, theoretical foundation (eg, cognitive-behavioral therapy, mindfulness) and duration
Comparator
No eligibility criteria
Outcomes

PICO 60.3

Population
Healthcare workers (eg, physicians, nurses); adults (≥18 years); irrespective of sex, health status, or country; diverse settings of study conduction eligible (eg, clinical setting, outpatient setting)
Intervention
Exposure to SARS-CoV-2 pandemic (i.e., survey period after the first officially registered SARS-CoV-2 case in the respective country based on national infection dates published by the World Health Organization [WHO]1); irrespective of medical care for COVID-19 patients (i.e., level of contact)
Comparator
No exposure to SARS-CoV-2 pandemic (i.e., before first officially registered SARS-CoV-2 case in the respective country based on national infection dates published by the WHO1)
Outcomes