Clinical management of COVID-19: living guideline

Published by World Health Organization (WHO) on Aug 18, 2023

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Abstract

© World Health Organization 2023


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Language

en-gb

PICOS

PICO 1.1

Population
Non-intubated patients with COVID-19 hypoxaemic respiratory failure
Intervention
Awake prone positioning + usual care
Comparator
No awake prone positioning
Outcomes

PICO 1.2

Population
Patients hospitalized with severe COVID-19 infection
Intervention
Awake prone positioning + usual care
Comparator
Usual care
Outcomes

PICO 2.1

Population
Asymptomatic COVID-19 patients
Intervention
Isolation for 5 days after positive test
Comparator
Isolation for 10 days after positive test
Outcomes

PICO 2.2

Population
Symptomatic COVID-19 patients 
Intervention
Isolation for 5 days after symptom onset
Comparator
Isolation for 10 days after symptom onset plus 3 additional days without symptoms
Outcomes

PICO 2.3

Population
Patients with COVID-19
Intervention
Remove isolation based on negative antigen test after Isolation 5 days
Comparator
Isolation for 10 days
Outcomes

PICO 12.1

Population
Patients treated at home with confirmed or suspected COVID-19 disease
Intervention
SpO2 < 92% (Pulse oximetry use at home)
Comparator
SpO2 ≥ 92% (Pulse oximetry use at home)
Outcomes

PICO 14.1

Population
Hospitalized patients with severe or critical COVID-19 and AHRF not needing emergent intubation
Intervention
HFNO
Comparator
SOT
Outcomes

PICO 14.2

Population
Hospitalized patients with severe or critical COVID-19 and AHRF not needing emergent intubation
Intervention
CPAP
Comparator
SOT
Outcomes

PICO 14.3

Population
Hospitalized patients with severe or critical COVID-19 and AHRF not needing emergent intubation
Intervention
Helmet NIV
Comparator
HFNO
Outcomes

PICO 14.4

Population
Hospitalized patients with severe or critical COVID-19 and AHRF not needing emergent intubation
Intervention
CPAP
Comparator
HFNO
Outcomes

PICO 14.5

Population
Hospitalized patients with ARDS and AHRF not needing emergent intubation
Intervention
HFNO
Comparator
SOT
Outcomes

PICO 14.6

Population
Hospitalized patients with ARDS and AHRF not needing emergent intubation
Intervention
Facemask NIV
Comparator
SOT
Outcomes

PICO 14.7

Population
Hospitalized patients with ARDS and AHRF not needing emergent intubation
Intervention
Helmet CPAP
Comparator
SOT
Outcomes

PICO 14.8

Population
Hospitalized patients with ARDS and AHRF not needing emergent intubation
Intervention
Face mask CPAP
Comparator
SOT
Outcomes

PICO 14.9

Population
Hospitalized patients with ARDS and AHRF who do not need emergent intubation
Intervention
Face mask NIV
Comparator
HFNO
Outcomes

PICO 14.10

Population
Hospitalized patients with ARDS and AHRF not needing emergent intubation
Intervention
Helmet NIV
Comparator
Face mask NIV
Outcomes

PICO 16.1

Population
Hospitalized patients without an indication for therapeutic anticoagulation
Intervention
Anticoagulation at therapeutic or intermediate intensity
Comparator
Anticoagulation at prophylactic intensity
Outcomes

PICO 16.2

Population
Patients with COVID-19 and ARDS or viral pneumonia who are critically ill in ICU, with or without invasive ventilation. Populations of children (defined <18 years) and adult patients (≥18 years)
Intervention
Existing validated care bundles*, chosen locally by the hospital or ICU, adapted to local circumstances, and felt to be appropriate for patients with COVID-19 as specified above. *A care bundle is defined as three or more evidence informed practices delivered together and consistently to improve care.
Comparator
Not using existing care bundles
Outcomes

PICO 17.1

Population
Children aged 0–19 years meeting any standard case definition of MIS-C in hospitals in high-income countries (HIC) and low- and middle-income countries (LMIC)
Intervention
IVIG plus steroids as the initial treatment
Comparator
IVIG alone as the initial treatment
Outcomes

PICO 17.2

Population
Children aged 0–19 years meeting any standard case definition of MIS-C in hospitals in high-income countries (HIC) and low- and middle-income countries (LMIC)
Intervention
IVIG plus steroids as the initial treatment
Comparator
Steroids alone as the initial treatment
Outcomes

PICO 17.3

Population
Children aged 0–19 years meeting any standard case definition of MIS-C in hospitals in high-income countries (HIC) and low- and middle-income countries (LMIC)
Intervention
Steroids alone as the initial treatment
Comparator
IVIG alone as the initial treatment
Outcomes

PICO 36.1

Population
OUTDATED? Hospitalized patients with severe or critical COVID 19 and AHRF not needing emergent intubation
Intervention
HFNO
Comparator
SOT
Outcomes