{Reference Type}: Systematic Review
{Title}: Pan-American Guidelines for the treatment of SARS-CoV-2/COVID-19: a joint evidence-based guideline of the Brazilian Society of Infectious Diseases (SBI) and the Pan-American Association of Infectious Diseases (API).
{Author}: Barbosa AN;Chebabo A;Starling C;Pérez C;Cunha CA;de Luna D;Nunes EP;Zambrano G;Ferreira JC;Croda J;Falavigna M;Gomes-da-Silva MM;Thormann M;Cimerman S;Parahiba SM;Tanni S;Bernardo WM;Rodriguez-Morales AJ;
{Journal}: Ann Clin Microbiol Antimicrob
{Volume}: 22
{Issue}: 1
{Year}: 2023 Aug 7
{Factor}: 6.781
{DOI}: 10.1186/s12941-023-00623-w
{Abstract}: <B>BACKGROUND: </B>Since the beginning of the COVID-19 pandemic, therapeutic options for treating COVID-19 have been investigated at different stages of clinical manifestations. Considering the particular impact of COVID-19 in the Americas, this document aims to present recommendations for the pharmacological treatment of COVID-19 specific to this population.<BR><B>METHODS: </B>Fifteen experts, members of the Brazilian Society of Infectious Diseases (SBI) and the Pan-American Association of Infectious Diseases (API) make up the panel responsible for developing this guideline. Questions were formulated regarding prophylaxis and treatment of COVID-19 in outpatient and inpatient settings. The outcomes considered in decision-making were mortality, hospitalisation, need for mechanical ventilation, symptomatic COVID-19 episodes, and adverse events. In addition, a systematic review of randomised controlled trials was conducted. The quality of evidence assessment and guideline development process followed the GRADE system.<BR><B>RESULTS: </B>Nine technologies were evaluated, and ten recommendations were made, including the use of tixagevimab + cilgavimab in the prophylaxis of COVID-19, tixagevimab + cilgavimab, molnupiravir, nirmatrelvir + ritonavir, and remdesivir in the treatment of outpatients, and remdesivir, baricitinib, and tocilizumab in the treatment of hospitalised patients with severe COVID-19. The use of hydroxychloroquine or chloroquine and ivermectin was discouraged.<BR><B>CONCLUSIONS: </B>This guideline provides recommendations for treating patients in the Americas following the principles of evidence-based medicine. The recommendations present a set of drugs that have proven effective in the prophylaxis and treatment of COVID-19, emphasising the strong recommendation for the use of nirmatrelvir/ritonavir in outpatients as the lack of benefit from the use of hydroxychloroquine and ivermectin.