单位：[1]School of Medicine, University of Dundee, Dundee, UK[2]Dept of Respiratory Medicine, AZNikolaas, Sint-Niklaas, Belgium[3]Dept of Respiratory and Critical Care Medicine, Clinical Microbiology andInfectious Disease Lab, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Instituteof Respiratory Medicine, Chinese Academy of Medical Science, National Clinical Research Center ofRespiratory Diseases, Beijing, China[4]Service de Pneumologie et Soins Intensifs, Hôpital Bicêtre, AssistancePublique-Hôpitaux de Paris (AP-HP), Université Paris-Saclay, Inserm UMR_S 999, Le Kremlin Bicêtre, France[5]Pulmonology Institute and CF Center, Carmel Medical Center and the Technion-Israel Institute ofTechnology, Haifa, Israel[6]Laboratory of Molecular and Cellular Pneumonology, Dept of Respiratory Medicine,School of Medicine, University of Crete, Heraklion, Greece[7]Dept of Respiratory Medicine, CopenhagenUniversity Hospital-Hvidovre Hospital, Hvidovre, Denmark[8]European Lung Foundation, Sheffield, UK[9]Dept ofPulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Centerof Respiratory Diseases, Beijing, China[10]KU Leuven Libraries – 2Bergen – Learning Centre Désiré Collen,Leuven, Belgium[11]Dept of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai, China[12]Instituteof Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China[13]Clinic ofRespiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland[14]Institutefor Lung Health, Leicester NIHR BRC, University of Leicester, Leicester, UK[15]Medizinische HochschuleHannover, Direktor der Abteilung Pneumologie, Hannover, Germany[16]Dept of Pathophysiology andTransplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy[17]Respiratory and Sleep Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK[18]Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland[19]Respiratory Medicine,Cochin Hospital, APHP Centre-University of Paris, Cochin Institute (INSERM UMR1016), Paris, France
Introduction: Hospitalised patients with coronavirus disease 2019 (COVID-19) as a result of SARS-CoV-2 infection have a high mortality rate and frequently require noninvasive respiratory support or invasive ventilation. Optimising and standardising management through evidence-based guidelines may improve quality of care and therefore patient outcomes. Methods: A task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions (pharmacological and non-pharmacological) for the initial version of this "living guideline" using the PICO (population, intervention, comparator, outcome) format. The GRADE approach was used for assessing the quality of evidence and strength of recommendations. Systematic literature reviews were performed, and data pooled by meta-analysis where possible. Evidence tables were presented and evidence to decision frameworks were used to formulate recommendations. Results: Based on the available evidence at the time of guideline development (20 February, 2021), the panel makes a strong recommendation in favour of the use of systemic corticostemids in patients requiring supplementary oxygen or ventilatory support, and for the use of anticoagulation in hospitalised patients. The panel makes a conditional recommendation for interleukin (IL)-6 receptor antagonist monoclonal antibody treatment and high-flow nasal oxygen or continuous positive airway pressure in patients with hypoxaemic respiratory failure. The panel make strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir. Conditional recommendations are made against the use of azithromycin, hydroxychloroquine combined with azithromycin, colchicine, and remdesivir, in the latter case specifically in patients requiring invasive mechanical ventilation. No recommendation was made for remdesivir in patients requiring supplemental oxygen. Further recommendations for research are made. Conclusion: The evidence base for management of COVID-19 now supports strong recommendations in favour and against specific interventions. These guidelines will be regularly updated as further evidence becomes available.
第一作者单位：[1]School of Medicine, University of Dundee, Dundee, UK[*1]Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
共同第一作者：
通讯作者：
通讯机构：[1]School of Medicine, University of Dundee, Dundee, UK[*1]Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
推荐引用方式(GB/T 7714)：
James D. Chalmers,Megan L. Crichton,Pieter C. Goeminne,et al.Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline[J].EUROPEAN RESPIRATORY JOURNAL.2021,57(4):doi:10.1183/13993003.00048-2021.
APA：
James D. Chalmers,Megan L. Crichton,Pieter C. Goeminne,Bin Cao,Marc Humbert...&Nicolas Roche.(2021).Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline.EUROPEAN RESPIRATORY JOURNAL,57,(4)
MLA：
James D. Chalmers,et al."Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline".EUROPEAN RESPIRATORY JOURNAL 57..4(2021)
医学