Abstract：
METHODS: Despite the large availability of vaccines, coronavirus disease 2019 (COVID-19), induced by severe acute respiratory syndrome coronavirus 2, continues to be a major threat for health-care providers and fragile people. A number of options are now available for outpatients with mild-to-moderate COVID-19 at the risk of disease progression for the prevention of deaths or hospitalization.
METHODS: A European Society of Clinical Microbiology and Infectious Diseases COVID-19 guidelines task force was established by the European Society of Clinical Microbiology and Infectious Diseases Executive Committee. A small group was established, half appointed by the chair and the remaining selected based on an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the population, intervention, comparison, outcome format was developed at the beginning of the process. For each population, intervention, comparison, outcome, two panel members performed a literature search, with a third panelist involved in case of inconsistent results. Voting was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
CONCLUSIONS: In this update, we focus on anti-viral agents, monoclonal antibodies (mAbs) and other treatment options proposed for patients with mild or moderate COVID-19 who are at the risk of hospitalization or death. Although the use of anti-virals is recommended, especially nirmatrelvir/ritonavir and remdesivir or, alternatively, molnupirarvir, the administration of mAbs against the spike protein strictly depends on circulating variants or the ability to test timely for variants and sub-variants. At the time of writing (April-June 2022), the only active mAb was tixagevimab/cilgavimab given the predominance of the Omicron BA.2, BA.3, BA.4 and BA.5 sub-lineages in Europe. However, considering that the epidemiological scenario is extremely dynamic, constant monitoring of variants of concern is mandatory.
METHODS: A European Society of Clinical Microbiology and Infectious Diseases COVID-19 guidelines task force was established by the European Society of Clinical Microbiology and Infectious Diseases Executive Committee. A small group was established, half appointed by the chair and the remaining selected based on an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the population, intervention, comparison, outcome format was developed at the beginning of the process. For each population, intervention, comparison, outcome, two panel members performed a literature search, with a third panelist involved in case of inconsistent results. Voting was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
CONCLUSIONS: In this update, we focus on anti-viral agents, monoclonal antibodies (mAbs) and other treatment options proposed for patients with mild or moderate COVID-19 who are at the risk of hospitalization or death. Although the use of anti-virals is recommended, especially nirmatrelvir/ritonavir and remdesivir or, alternatively, molnupirarvir, the administration of mAbs against the spike protein strictly depends on circulating variants or the ability to test timely for variants and sub-variants. At the time of writing (April-June 2022), the only active mAb was tixagevimab/cilgavimab given the predominance of the Omicron BA.2, BA.3, BA.4 and BA.5 sub-lineages in Europe. However, considering that the epidemiological scenario is extremely dynamic, constant monitoring of variants of concern is mandatory.
摘要：
方法：尽管疫苗数量众多，2019年冠状病毒病（COVID-19），由严重急性呼吸道综合症冠状病毒2引起的，仍然是医疗保健提供者和脆弱人群的主要威胁。对于有疾病进展风险的轻中度COVID-19门诊患者，现在有许多选择，以预防死亡或住院。
方法：欧洲临床微生物学和传染病学会执行委员会成立了欧洲临床微生物学和传染病学会COVID-19指南工作组。成立了一个小组，一半由主席任命，剩下的根据公开电话选择。每个小组几乎每周开会一次。对于所有的决定,使用了简单的多数票。一长串使用人群的临床问题，干预，比较,结果格式是在过程开始时开发的。对于每个人口，干预，比较,结果,两名小组成员进行了文献检索，第三个小组成员参与了不一致的结果。投票是基于建议评估的等级，开发和评估(等级)方法。
结论：在此更新中，我们专注于抗病毒药物，为有住院或死亡风险的轻度或中度COVID-19患者提出的单克隆抗体（mAb）和其他治疗方案。尽管建议使用抗病毒药物，尤其是尼马特雷韦/利托那韦和雷姆德西韦或，或者，Molnupirarvir,针对刺突蛋白的mAb的施用严格取决于循环变体或及时测试变体和亚变体的能力。在撰写本文时（2022年4月至6月），鉴于欧洲的OmicronBA.2，BA.3，BA.4和BA.5子谱系占主导地位，唯一有活性的mAb是tixagevimab/cilgavimab。然而,考虑到流行病学情景是非常动态的，不断监测关注的变体是强制性的。
方法：欧洲临床微生物学和传染病学会执行委员会成立了欧洲临床微生物学和传染病学会COVID-19指南工作组。成立了一个小组，一半由主席任命，剩下的根据公开电话选择。每个小组几乎每周开会一次。对于所有的决定,使用了简单的多数票。一长串使用人群的临床问题，干预，比较,结果格式是在过程开始时开发的。对于每个人口，干预，比较,结果,两名小组成员进行了文献检索，第三个小组成员参与了不一致的结果。投票是基于建议评估的等级，开发和评估(等级)方法。
结论：在此更新中，我们专注于抗病毒药物，为有住院或死亡风险的轻度或中度COVID-19患者提出的单克隆抗体（mAb）和其他治疗方案。尽管建议使用抗病毒药物，尤其是尼马特雷韦/利托那韦和雷姆德西韦或，或者，Molnupirarvir,针对刺突蛋白的mAb的施用严格取决于循环变体或及时测试变体和亚变体的能力。在撰写本文时（2022年4月至6月），鉴于欧洲的OmicronBA.2，BA.3，BA.4和BA.5子谱系占主导地位，唯一有活性的mAb是tixagevimab/cilgavimab。然而,考虑到流行病学情景是非常动态的，不断监测关注的变体是强制性的。
