Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Management of hospitalised adults with coronavirus disease 2019 (COVID-19): A European Respiratory Society living guideline

Research output: Contribution to journalReviewResearchpeer-review

  1. The effect of tezepelumab on airway hyperresponsiveness to mannitol in asthma (UPSTREAM)

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Phenotype and severity of asthma determines bronchial epithelial immune responses to a viral mimic

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Occupational inhalant exposures and longitudinal lung function decline

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Socioeconomic biases in asthma control and specialist referral of possible severe asthma

    Research output: Contribution to journalJournal articleResearchpeer-review

  • James D Chalmers
  • Megan L Crichton
  • Pieter C Goeminne
  • Bin Cao
  • Marc Humbert
  • Michal Shteinberg
  • Katerina M Antoniou
  • Charlotte Suppli Ulrik
  • Helen Parks
  • Chen Wang
  • Thomas Vandendriessche
  • Jieming Qu
  • Daiana Stolz
  • Christopher Brightling
  • Tobias Welte
  • Stefano Aliberti
  • Anita K Simonds
  • Thomy Tonia
  • Nicolas Roche
View graph of relations

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 corticosteroids 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.

Original languageEnglish
Article number2100048
JournalThe European respiratory journal
Issue number4
Publication statusPublished - 15 Apr 2021

    Research areas

  • Adrenal Cortex Hormones/therapeutic use, Adult, COVID-19/therapy, Hospitalization, Humans, Meta-Analysis as Topic, Respiration, Artificial, Systematic Reviews as Topic

ID: 64228456