ESCMID COVID-19 living guidelines: drug treatment and clinical management

Availability of oral antivirals against SARS-CoV-2 infection and the requirement for an ethical prescribing approach

“…Most patients with COVID-19 who begin treatment with a SARS-CoV-2 oral antiviral in the upcoming months will not be included in any research protocol. Although it would be expected that international organisations (eg, WHO 59 and the European Centre for Disease Prevention and Control 60 ) and professional infectious diseases associations (eg, the European Society of Clinical Microbiology and Infectious Diseases 61 and Infectious Diseases Society of America 62 ) would be diligent in including these antivirals in their guidelines on the treatment of patients with COVID-19, this guidance is unlikely to address the issue discussed. All countries aiming to make nirmatrelvir–ritonavir and molnupiravir available for their patients should prepare a policy that ensures the fair prescription of these medicines to all eligible patients.…”

Predictors of poor outcome in tocilizumab treated patients with Sars-CoV-2 related severe respiratory failure: A multicentre real world study

“…Meta-analyses showed that Tocilizumab significantly reduce the relative risk of 30-day mortality of around 10-15% and the risk of mechanical ventilation of around 20-26%, without increasing the risk of infection and/or adverse events [9] , [10] . Based on favourable evidence, international guidelines suggest touse Tocilizumab in patients with severe SARS-CoV-2 related respiratory failure [11] . Despite this evidence, 30-day mortality and invasive mechanical ventilation risks in patients treated with Tocilizumab remain not negligible, being 24.6% and 10.3% respectively in randomized clinical trials, and 25.5% and 17.1% respectively in cohort studies [9] .…”

Safety and Efficacy of Ivermectin for the Prevention and Treatment of COVID-19: A Double-Blinded Randomized Placebo-Controlled Study

“…Several randomized controlled trials on the efficacy of ivermectin for treating COVID-19 have shown conflicting results in terms of virological and clinical outcomes [ 15 , 16 ]. However, our study results were in line with several well-controlled studies.…”