Lessons Learned from Coronavirus Disease 2019 (COVID-19) Therapies: Critical Perspectives From the Infectious Diseases Society of America (IDSA) COVID-19 Treatment Guideline Panel

Bhimraj, Adarsh; Shumaker, Amy Hirsch; Baden, Lindsey R.; Cheng, Vincent Chi-Chung; Edwards, Kathryn M.; Gandhi, Rajesh T.; Gallagher, Jason C; Muller, William J.; O’Horo, John C.; Shoham, Shmuel; Wollins, Dana S.; Falck‐Ytter, Yngve

doi:10.1093/cid/ciab882

Cited by 20 publications

(13 citation statements)

References 19 publications

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“… The percentage of sites recommending use of each clinical intervention for a given patient population, stratified by disease severity, is presented alongside simplified findings from notable RCTs (eAppendix in the Supplement ) and guidelines available at the time of the survey from the National Institutes of Health (NIH), 2 Infectious Diseases Society of America (IDSA), 3 and American Society of Hematology (ASH). 4 No published RCTs were available at the time of the survey for anticoagulation or proning.…”

Section: Resultsmentioning

confidence: 99%

Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

et al. 2022

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Section: Resultsmentioning

confidence: 99%

Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

et al. 2022

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“…The COVID-19 pandemic brought by SARS-CoV-2 has caused a tremendous death toll and economic burden in the world, killing at least three million infected persons (27). In the current existing clinical treatment, some chemotherapeutics that may be used in the clinics, such as hydroxychloroquine, dexamethasone, and lopinavir-ritonavir, may be prescribed for potential COVID-19 therapy.…”

Section: Discussionmentioning

confidence: 99%

Luteolin Potentially Treating Prostate Cancer and COVID-19 Analyzed by the Bioinformatics Approach: Clinical Findings and Drug Targets

Huang

Chen

et al. 2022

Front. Endocrinol.

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Coronavirus disease 2019 (COVID-19) is a serious epidemic, characterized by potential mutation and can bring about poor vaccine efficiency. It is evidenced that patients with malignancies, including prostate cancer (PC), may be highly vulnerable to the SARS-CoV-2 infection. Currently, there are no existing drugs that can cure PC and COVID-19. Luteolin can potentially be employed for COVID-19 treatment and serve as a potent anticancer agent. Our present study was conducted to discover the possible drug target and curative mechanism of luteolin to serve as treatment for PC and COVID-19. The differential gene expression of PC cases was determined via RNA sequencing. The application of network pharmacology and molecular docking aimed to exhibit the drug targets and pharmacological mechanisms of luteolin. In this study, we found the top 20 up- and downregulated gene expressions in PC patients. Enrichment data demonstrated anti-inflammatory effects, where improvement of metabolism and enhancement of immunity were the main functions and mechanism of luteolin in treating PC and COVID-19, characterized by associated signaling pathways. Additional core drug targets, including MPO and FOS genes, were computationally identified accordingly. In conclusion, luteolin may be a promising treatment for PC and COVID-19 based on bioinformatics findings, prior to future clinical validation and application.

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“…A Bayesian framework allows frequent looks into the data in context of interim analyses [e.g., multiplatform analysis for anticoagulation (94)]. As we show in our analysis, platform trials were a success story in the clinical research agenda of COVID-19, strongly impacting international treatment guidelines, while delivering fast and profound evidence (4,95). The SOLIDARITY (83), RECOVERY (28,82), and REMAP-CAP (23) platform trials were based on a blueprint or pre-existing protocol prepared by scientific networks (e.g., WHO R&D Blueprint group).…”

Section: Body Of Evidence Evolving Over Timementioning

confidence: 93%

Clinical Evidence Informing Treatment Guidelines on Repurposed Drugs for Hospitalized Patients During the Early COVID-19 Pandemic: Corticosteroids, Anticoagulants, (Hydroxy)chloroquine

Wüstner

Hogger

Gartner-Freyer

et al. 2022

Front. Public Health

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IntroductionIn early 2020, the coronavirus disease 2019 (COVID-19) pandemic spread worldwide, overwhelming hospitals with severely ill patients and posing the urgent need for clinical evidence to guide patient care. First treatment options available were repurposed drugs to fight inflammation, coagulopathy, and viral replication. A vast number of clinical studies were launched globally to test their efficacy and safety. Our analysis describes the development of global evidence on repurposed drugs, in particular corticosteroids, anticoagulants, and (hydroxy)chloroquine in hospitalized COVID-19 patients based on different study types. We track the incorporation of clinical data in international and national treatment guidelines and identify factors that characterize studies and analyses with the greatest impact on treatment recommendations.MethodsA literature search in MEDLINE was conducted to assess the clinical evidence on treatment with corticosteroids, anticoagulants, and (hydroxy)chloroquine in hospitalized COVID-19 patients during the first year of the pandemic. Adoption of the evidence from this clinical data in treatment guidelines of the World Health Organization (WHO), Germany, and United States (US) was evaluated over time.ResultsWe identified 106 studies on corticosteroids, 141 studies on anticoagulants, and 115 studies on (hydroxy)chloroquine. Most studies were retrospective cohort studies; some were randomized clinical trials (RCTs), and a few were platform trials. These studies were compared to studies directly and indirectly referred to in WHO (7 versions), German (5 versions), and US (21 versions) guidelines. We found that initially large, well-adjusted, mainly retrospective cohort studies and ultimately large platform trials or coordinated meta-analyses of RCTs provided best available clinical evidence supporting treatment recommendations.DiscussionParticularly early in the pandemic, evidence for the efficacy and safety of repurposed drugs was of low quality, since time and scientific rigor seemed to be competing factors. Pandemic preparedness, coordinated efforts, and combined analyses were crucial to generating timely and robust clinical evidence that informed national and international treatment guidelines on corticosteroids, anticoagulants, and (hydroxy)chloroquine. Multi-arm platform trials with master protocols and coordinated meta-analyses proved particularly successful, with researchers joining forces to answer the most pressing questions as quickly as possible.

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Lessons Learned from Coronavirus Disease 2019 (COVID-19) Therapies: Critical Perspectives From the Infectious Diseases Society of America (IDSA) COVID-19 Treatment Guideline Panel

Cited by 20 publications

References 19 publications

Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

Luteolin Potentially Treating Prostate Cancer and COVID-19 Analyzed by the Bioinformatics Approach: Clinical Findings and Drug Targets

Clinical Evidence Informing Treatment Guidelines on Repurposed Drugs for Hospitalized Patients During the Early COVID-19 Pandemic: Corticosteroids, Anticoagulants, (Hydroxy)chloroquine

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