Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists. Annex no. 2 as of October 13, 2020

Flisiak, Robert; Parczewski, Miłosz; Horban, Andrzéj; Jaroszewicz, Jerzy; Kozielewicz, Dorota; Pawłowska, Małgorzata; Piekarska, Anna; Simon, Krzysztof; Tomasiewicz, Krzysztof; Zarębska-Michaluk, Dorota

doi:10.20452/pamw.15658

Cited by 49 publications

(51 citation statements)

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“…The patient received therapy according to current recommendations of the Polish Association of Epidemiologists and Infectious Disease Specialists [13]. Such therapy should be com- posed of oxygen via nasal cannula or ventilation mask, depending on the degree of hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

“…Such therapy should be com- posed of oxygen via nasal cannula or ventilation mask, depending on the degree of hypoxemia. In addition, corticosteroids (dexamethasone), antibiotics, and LMWH in a prophylactic or therapeutic dose are recommended [13]. Taccone et al documented that a high-dose regimen of thromboprophylaxis therapy may decrease the occurrence of venous thromboembolic disease in critically ill SARS-CoV-2 patients [14].…”

Section: Discussionmentioning

confidence: 99%

“…The use of corticosteroids (CS) in SARS-CoV-2 lung disease is the most controversial issue in terms of pharmacological therapy. According to Polish guidelines, CS are recommended in standard doses (prednisone 0.5-1 mg/kg body mass per day) in patients with respiratory insufficiency in whom SaO 2 drops below 90% [13]. The firstline CS is dexamethasone, used in an average dose of 8 mg/day.…”

Section: Discussionmentioning

confidence: 99%

“…According to Polish recommendations, higher doses of CS may be considered in patients who present with a cytokine storm. The preferred treatment in the event of a cytokine storm is an anti-IL 6 drug named tocilizumab [13].…”

Section: Discussionmentioning

confidence: 99%

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SARS-CoV-2 Lung Disease in a Patient with Pulmonary Sarcoidosis—Case Report

Opoka¹,

Wyrostkiewicz²,

Winek³

et al. 2020

Advances in Respiratory Medicine

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the recently identified cause of the current pandemic. In patients with chronic respiratory lung diseases, SARS-CoV-2 may result in significant morbidity and increased mortality. We present a case of a 69-year-old male with stage II pulmonary sarcoidosis who had been under observation for 30 months without immunosuppressive treatment. He then developed severe SARS-CoV-2 disease with typical radiological and laboratory findings. Therapy with oxygen, antibiotics, low-molecular-weight heparin in a prophylactic dose, and dexamethasone resulted in marked clinical improvement. We will discuss the rationale for corticosteroid use in both SARS-CoV-2 disease and in SARS-CoV-2 disease that is complicating comorbid sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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SARS-CoV-2 Lung Disease in a Patient with Pulmonary Sarcoidosis—Case Report

Opoka¹,

Wyrostkiewicz²,

Winek³

et al. 2020

Advances in Respiratory Medicine

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“…This ongoing project, supported by the Polish Association of Epidemiologists and Infectiologists, is a national real-world experience study assessing treatment in patients with COVID-19. The decision about the treatment regimen was taken entirely by the treating physician concerning current knowledge and recommendations of the Polish Association of Epidemiologists and Infectiologists [15, 16, 17]. The SARSTer study was approved by the Ethical Committee of the Medical University of Białystok.…”

Section: Methodsmentioning

confidence: 99%

Administration of tocilizumab to patients with high concentrations of IL-6 in the course of COVID-19 is associated with a better prognosis

Flisiak

Jaroszewicz

Rogalska

et al. 2021

Preprint

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SummaryBackgroundDespite the direct viral activity, the pathogenesis of coronavirus disease 2019 (COVID-19) includes an overproduction of cytokines including interleukin 6 (IL-6). Therefore tocilizumab (TCZ), a monoclonal antibody against IL-6 receptors, became considered as a possible therapeutic option.MethodsPatients were selected from the SARSTer national database, which included 2332 individuals with COVID-19 and the current study included 825 adult patients with moderate to severe course. The retrospective analysis was performed in 170 patients treated with TCZ and 655 without this medication or any other anti-cytokine therapy. The end-points of treatment effectiveness were a rate of death, need for mechanical ventilation, and clinical improvement.ResultsPatients treated with TCZ were balanced compared to non-TCZ regarding gender, age, BMI, and prevalence of coexisting conditions. The reduced death rate was demonstrated in patients treated with TCZ and baseline IL-6 >100 pg/ml (hazard ratio [HR]: 0.27, 95% confidence interval [CI]:0.10-0.78), or those needing oxygen supplementations who worsened within 7 days of hospitalization (HR: 0.38, 95% CI:0.16-0.88). The best effectiveness of TCZ was achieved in patients with a combination of baseline IL-6>100 pg/ml and either SpO2≤90% (HR for death, mechanical ventilation, and clinical improvement after 21 or 28 days: 0.07, 0.14, 5.53, 5.18 respectively) or requiring oxygen supplementation (HR for death and clinical improvement after 21 or 28 days, 0.18, 2.66, 2.85 respectively).ConclusionsTocilizumab administered for COVID-19 in patients with a baseline concentration of IL-6>100 pg/ml is associated with reduced mortality and faster clinical improvement, particularly if there is a need for oxygen supplementation due to SpO2≤90%.

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Adherence of Clinical Practice Guidelines for Pharmacologic Treatments of Hospitalized Patients With COVID-19 to Trustworthy Standards

et al. 2021

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Key Points Question Do clinical practice guidelines (CPGs) that report on pharmacologic treatments of hospitalized patients with COVID-19 meet the National Academy of Medicine standards for trustworthiness? Findings In this systematic review of 32 CPGs of predominantly low quality, few reported funding sources or conflicts of interest, included a methodologist, described a search strategy or study selection process, or synthesized evidence. Although 14 CPGs (43.8%) made recommendations or suggestions for or against treatments, they infrequently rated the confidence in the quality of the evidence (6 [18.8%]), described potential benefits and harms (6 [18.8%]), or graded the strength of recommendations (5 [15.6%]). Meaning The findings of this study suggest that few COVID-19 CPGs meet National Academy of Medicine standards for trustworthy guidelines.

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Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists. Annex no. 2 as of October 13, 2020

Cited by 49 publications

References 0 publications

SARS-CoV-2 Lung Disease in a Patient with Pulmonary Sarcoidosis—Case Report

SARS-CoV-2 Lung Disease in a Patient with Pulmonary Sarcoidosis—Case Report

Administration of tocilizumab to patients with high concentrations of IL-6 in the course of COVID-19 is associated with a better prognosis

Adherence of Clinical Practice Guidelines for Pharmacologic Treatments of Hospitalized Patients With COVID-19 to Trustworthy Standards

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