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

Published by Australian National Clinical Evidence Taskforce on May 29, 2023

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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

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Abstract

Language

en-au

PICOS

PICO 10.1

Population
Outpatients with mild COVID-19
Intervention
Casirivimab plus imdevimab
Comparator
Placebo
Outcomes

PICO 10.1

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

PICO 10.1

Population
Patients with COVID-19 patients
Intervention
Continuous positive airway pressure
Comparator
Conventional oxygen therapy
Outcomes

PICO 10.1

Population
Casirivimab-imdevimab prophylaxis for COVID-19
Intervention
Casirivimab plus imdevimab
Comparator
Placebo
Outcomes

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

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

PICO 10.1

Population
Patients with COVID-19
Intervention
Abatacept
Comparator
Placebo
Outcomes

PICO 10.1

Population
Patients with COVID-19
Intervention
Nirmatrelvir plus ritonavir
Comparator
Placebo
Outcomes

PICO 10.1

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

PICO 10.2

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

PICO 10.2

Population
Patients hospitalised with COVID-19
Intervention
Casirivimab plus imdevimab
Comparator
Standard care
Outcomes

PICO 10.2

Population
NEW Casirivimab-imdevimab prophylaxis for COVID-19
Intervention
Casirivimab plus imdevimab
Comparator
Placebo
Outcomes

PICO 10.2

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

PICO 10.2

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 10.2

Population
Apixaban for thromboembolism following acute COVID-19
Intervention
Prophylactic anticoagulation with apixaban
Comparator
No anticoagulation
Outcomes

PICO 10.2

Population
Dexamethasone dosing for COVID-19
Intervention
High-dose dexamethasone
Comparator
Low-dose dexamethasone
Outcomes

PICO 10.2

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

PICO 10.3

Population
Patients with COVID-19
Intervention
Remdesivir Plus Tocilizumab
Comparator
Remdesivir
Outcomes

PICO 10.3

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

PICO 10.3

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 10.4

Population
Outpatients with mild COVID-19
Intervention
Remdesivir
Comparator
Placebo
Outcomes

PICO 10.4

Population
NEW Patients with COVID-19 patients
Intervention
Continuous positive airway pressure
Comparator
Conventional oxygen therapy
Outcomes

PICO 10.5

Population
NEW solidarity 4 May 2022 Patients with COVID-19
Intervention
Remdesivir
Comparator
Standard care
Outcomes

PICO 10.5

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

PICO 20.1

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

PICO 20.1

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

PICO 20.1

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

PICO 20.1

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

PICO 20.1

Population
Patients with COVID-19
Intervention
Empagliflozin or dapagliflozin
Comparator
Placebo
Outcomes

PICO 20.1

Population
Patients with COVID-19
Intervention
Inhaled corticosteroids
Comparator
Control
Outcomes

PICO 20.1

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

PICO 20.2

Population
NEW Patients with COVID-19
Intervention
Inhaled corticosteroids
Comparator
Control
Outcomes

PICO 20.2

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

PICO 20.2

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

PICO 20.3

Population
NEW Patients with COVID-19
Intervention
Inhaled corticosteroids
Comparator
Control
Outcomes

PICO 30.1

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

PICO 30.1

Population
People with breathlessness, with or without anxiety, 4 weeks following the onset of COVID-19
Intervention
Breathing retraining and wellbeing
Comparator
Standard care
Outcomes

PICO 30.1

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

PICO 30.1

Population
EXEMPLAR evidence summary
Intervention
Comparator
Outcomes

PICO 30.1

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

PICO 30.1

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

PICO 30.1

Population
Patients requiring emergency intubation
Intervention
Videolaryngoscopy
Comparator
Direct laryngoscopy
Outcomes

PICO 30.1

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

PICO 30.1

Population
Patients with COVID-19
Intervention
Infliximab
Comparator
Placebo
Outcomes

PICO 30.2

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

PICO 30.2

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

PICO 40.1

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 40.1

Population
Molnupiravir for COVID-19
Intervention
Molnupiravir
Comparator
Usual care
Outcomes

PICO 40.1

Population
Evusheld for COVID-19 prophylaxis
Intervention
Evusheld
Comparator
Placebo – pre-exposure prophylaxis
Outcomes

PICO 40.1

Population
Vilobelimap for Covid-19
Intervention
Vilobelimap
Comparator
Placebo
Outcomes

PICO 40.1

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 40.1

Population
Patients with COVID-19
Intervention
Convalescent plasma
Comparator
Standard care
Outcomes

PICO 40.1

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

PICO 40.1

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

PICO 40.2

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

PICO 40.2

Population
Almitrinie for COVID-19
Intervention
Almitrine
Comparator
Placebo
Outcomes

PICO 40.2

Population
Patients with COVID-19 (no oxygen)
Intervention
Convalescent plasma
Comparator
Standard care
Outcomes

PICO 40.3

Population
Almitrine for COVID-19
Intervention
Almitrine
Comparator
placebo
Outcomes

PICO 50.1

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

PICO 50.1

Population
Evusheld for COVID-19 prophylaxis
Intervention
Evusheld
Comparator
Placebo – post-exposure prophylaxis
Outcomes

PICO 50.1

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

PICO 60.1

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

PICO 60.1

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

PICO 60.1

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

PICO 60.2

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

PICO 70.1

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

PICO 70.1

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

PICO 70.1

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

PICO 70.2

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

PICO 70.2

Population
People with COVID-19 (not requiring oxygen)
Intervention
Regdanvimab
Comparator
Placebo
Outcomes

PICO 80.1

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

PICO 80.1

Population
Evusheld for COVID-19 prophylaxis
Intervention
Evusheld
Comparator
Placebo
Outcomes

PICO 90.1

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

PICO 90.1

Population
Patients with mild or moderate COVID-19
Intervention
Sotrovimab
Comparator
Placebo
Outcomes

PICO 100.1

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

PICO 100.1

Population
Patients with COVID-19 (not requiring oxygen)
Intervention
Evusheld
Comparator
Placebo
Outcomes

PICO 100.2

Population
Patients with COVID-19 (requiring oxygen)
Intervention
Evusheld
Comparator
Placebo
Outcomes

PICO 100.2

Population
Ivermectin versus standard care for COVID-19
Intervention
Ivermectin
Comparator
standard care
Outcomes

PICO 110.1

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

PICO 120.1

Population
Patients with COIVD 19
Intervention
Empagliflozin or dapagliflozin
Comparator
Standard care
Outcomes

PICO 140.1

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

PICO 170.1

Population
Treatment A for Condition X
Intervention
Treatment A
Comparator
usual care
Outcomes

PICO 170.2

Population
Treatment A for Condition X
Intervention
Treatment A
Comparator
usual care
Outcomes