Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)

Chunxue Bai; Sanjay H. Chotirmall; Jordi Rello; George A. Alba; Leo C. Ginns; Jerry A. Krishnan; Robert Rogers; Elisabeth Bendstrup; Pierre Regis Burgel; James D. Chalmers; Abigail Chua; Kristina A. Crothers; Abhijit Duggal; Yeon Wook Kim; John G. Laffey; Carlos M. Luna; Michael S. Niederman; Ganesh Raghu; Julio A. Ramirez; Jordi Riera; Oriol Roca; Maximiliano Tamae-Kakazu; Antoni Torres; Richard R. Watkins; Miriam Barrecheguren; Mirko Belliato; Hassan A. Chami; Rongchang Chen; Gustavo A. Cortes-Puentes; Charles Delacruz; Margaret M. Hayes; Leo M.A. Heunks; Steven R. Holets; Catherine L. Hough; Sugeet Jagpal; Kyeongman Jeon; Takeshi Johkoh; May M. Lee; Janice Liebler; Gerry N. McElvaney; Ari Moskowitz; Richard A. Oeckler; Iñigo Ojanguren; Anthony O’regan; Mathias W. Pletz; Chin Kook Rhee; Marcus J. Schultz; Enrico Storti; Charlie Strange; Carey C. Thomson; Francesca J. Torriani; Xun Wang; Wim Wuyts; Tao Xu; Dawei Yang; Ziqiang Zhang; Kevin C. Wilson

doi:10.1183/16000617.0287-2020

Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)

Chunxue Bai, Sanjay H. Chotirmall, Jordi Rello, George A. Alba, Leo C. Ginns, Jerry A. Krishnan, Robert Rogers, Elisabeth Bendstrup, Pierre Regis Burgel, James D. Chalmers, Abigail Chua, Kristina A. Crothers, Abhijit Duggal, Yeon Wook Kim, John G. Laffey, Carlos M. Luna, Michael S. Niederman, Ganesh Raghu, Julio A. Ramirez, Jordi RieraOriol Roca, Maximiliano Tamae-Kakazu, Antoni Torres, Richard R. Watkins, Miriam Barrecheguren, Mirko Belliato, Hassan A. Chami, Rongchang Chen, Gustavo A. Cortes-Puentes, Charles Delacruz, Margaret M. Hayes, Leo M.A. Heunks, Steven R. Holets, Catherine L. Hough, Sugeet Jagpal, Kyeongman Jeon, Takeshi Johkoh, May M. Lee, Janice Liebler, Gerry N. McElvaney, Ari Moskowitz, Richard A. Oeckler, Iñigo Ojanguren, Anthony O’regan, Mathias W. Pletz, Chin Kook Rhee, Marcus J. Schultz, Enrico Storti, Charlie Strange, Carey C. Thomson, Francesca J. Torriani, Xun Wang, Wim Wuyts, Tao Xu, Dawei Yang, Ziqiang Zhang, Kevin C. Wilson

Department of Medicine

Research output: Contribution to journal › Review article › peer-review

79 Scopus citations

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.

Original language	English (US)
Article number	200287
Pages (from-to)	1-15
Number of pages	15
Journal	European Respiratory Review
Volume	29
Issue number	157
DOIs	https://doi.org/10.1183/16000617.0287-2020
State	Published - Sep 30 2020

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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10.1183/16000617.0287-2020

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Bai, C., Chotirmall, S. H., Rello, J., Alba, G. A., Ginns, L. C., Krishnan, J. A., Rogers, R., Bendstrup, E., Burgel, P. R., Chalmers, J. D., Chua, A., Crothers, K. A., Duggal, A., Kim, Y. W., Laffey, J. G., Luna, C. M., Niederman, M. S., Raghu, G., Ramirez, J. A., ... Wilson, K. C. (2020). Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020). European Respiratory Review, 29(157), 1-15. Article 200287. https://doi.org/10.1183/16000617.0287-2020

Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020). / Bai, Chunxue; Chotirmall, Sanjay H.; Rello, Jordi et al.
In: European Respiratory Review, Vol. 29, No. 157, 200287, 30.09.2020, p. 1-15.

Research output: Contribution to journal › Review article › peer-review

Bai, C, Chotirmall, SH, Rello, J, Alba, GA, Ginns, LC, Krishnan, JA, Rogers, R, Bendstrup, E, Burgel, PR, Chalmers, JD, Chua, A, Crothers, KA, Duggal, A, Kim, YW, Laffey, JG, Luna, CM, Niederman, MS, Raghu, G, Ramirez, JA, Riera, J, Roca, O, Tamae-Kakazu, M, Torres, A, Watkins, RR, Barrecheguren, M, Belliato, M, Chami, HA, Chen, R, Cortes-Puentes, GA, Delacruz, C, Hayes, MM, Heunks, LMA, Holets, SR, Hough, CL, Jagpal, S, Jeon, K, Johkoh, T, Lee, MM, Liebler, J, McElvaney, GN, Moskowitz, A, Oeckler, RA, Ojanguren, I, O’regan, A, Pletz, MW, Rhee, CK, Schultz, MJ, Storti, E, Strange, C, Thomson, CC, Torriani, FJ, Wang, X, Wuyts, W, Xu, T, Yang, D, Zhang, Z & Wilson, KC 2020, 'Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)', European Respiratory Review, vol. 29, no. 157, 200287, pp. 1-15. https://doi.org/10.1183/16000617.0287-2020

@article{c0e3244d08464ee39ef2a5254d69c032,

title = "Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)",

abstract = "Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.",

author = "Chunxue Bai and Chotirmall, {Sanjay H.} and Jordi Rello and Alba, {George A.} and Ginns, {Leo C.} and Krishnan, {Jerry A.} and Robert Rogers and Elisabeth Bendstrup and Burgel, {Pierre Regis} and Chalmers, {James D.} and Abigail Chua and Crothers, {Kristina A.} and Abhijit Duggal and Kim, {Yeon Wook} and Laffey, {John G.} and Luna, {Carlos M.} and Niederman, {Michael S.} and Ganesh Raghu and Ramirez, {Julio A.} and Jordi Riera and Oriol Roca and Maximiliano Tamae-Kakazu and Antoni Torres and Watkins, {Richard R.} and Miriam Barrecheguren and Mirko Belliato and Chami, {Hassan A.} and Rongchang Chen and Cortes-Puentes, {Gustavo A.} and Charles Delacruz and Hayes, {Margaret M.} and Heunks, {Leo M.A.} and Holets, {Steven R.} and Hough, {Catherine L.} and Sugeet Jagpal and Kyeongman Jeon and Takeshi Johkoh and Lee, {May M.} and Janice Liebler and McElvaney, {Gerry N.} and Ari Moskowitz and Oeckler, {Richard A.} and I{\~n}igo Ojanguren and Anthony O{\textquoteright}regan and Pletz, {Mathias W.} and Rhee, {Chin Kook} and Schultz, {Marcus J.} and Enrico Storti and Charlie Strange and Thomson, {Carey C.} and Torriani, {Francesca J.} and Xun Wang and Wim Wuyts and Tao Xu and Dawei Yang and Ziqiang Zhang and Wilson, {Kevin C.}",

note = "Funding Information: Conflict of interest: C. Bai has nothing to disclose. S.H. Chotirmall has nothing to disclose. J. Rello has nothing to disclose. G.A. Alba has nothing to disclose. L.C. Ginns has nothing to disclose. J.A. Krishnan reports grants from National Institutes of Health, Regeneron/Department of Health and Human Services, and Verily for COVID-19 studies outside the submitted work. R. Rogers has nothing to disclose. E. Bendstrup reports grants and personal fees from Hofmann la Roche and Boehringer Ingelheim, outside the submitted work. P-R. Burgel reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Insmed, Novartis, Pfizer, Teva and Zambon, and grants and personal fees from Vertex and GSK, outside the submitted work. J.D. Chalmers reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Glaxosmithkline, Insmed and Novartis, personal fees from Chiesi and Zambon, and grants from Gilead, outside the submitted work. A. Chua has nothing to disclose. K.A. Crothers has nothing to disclose. A. Duggal has nothing to disclose. Y.W. Kim has nothing to disclose. J.G. Laffey has nothing to disclose. C.M. Luna has nothing to disclose. M.S. Niederman reports other funding from Abbvie and Merck, outside the submitted work. G. Raghu reports consultant fees from Boerhinger Ingelheim, Roche-Genentech, Blade therapeutics, PureTech Health and Humanetics corporation. J.A. Ramirez has nothing to disclose. J. Riera has nothing to disclose. O. Roca provides consultancy to Hamilton Medical but did not receive any personal fees. All compensations were received by the Institute of Research of his institution. He also reports personal fees from Air Liquide, outside the submitted work. M. Tamae-Kakazu has nothing to disclose. A. Torres has nothing to disclose. R.R. Watkins has nothing to disclose. M. Barrecheguren reports speaker fees from Grifols, Menarini, CSL Behring, Boehringer Ingelheim and GSK, and consulting fees from GSK and Novartis, outside the submitted work. M. Belliato has nothing to disclose. H.A. Chami reports grants, personal fees and non-financial support from Pfizer, and personal fees from Boehringer Ingelheim, MSD, Novartis, Mundipharma and AstraZeneca, outside the submitted work. R. Chen has nothing to disclose. G.A. Cortes Puentes has nothing to disclose. C. Delacruz has nothing to disclose. M.M. Hayes has nothing to disclose. L.M.A. Heunks reports grants from Liberate medical, USA, personal fees from Getinge Critical Care, Sweden, and grants and personal fees from Orion Pharma, Finland, outside the submitted work. S.R. Holets has nothing to disclose. C.L. Hough has nothing to disclose. S. Jagpal was a sub-investigator for the RWJ New Brunswick Remdesivir study. S. Jeon has nothing to disclose. K. Johkoh has nothing to disclose. M.M. Lee has nothing to disclose. J. Liebler has nothing to disclose. G.N. McElvaney has nothing to disclose. A. Moskowitz has nothing to disclose. R.A. Oeckler has nothing to disclose. I. Ojanguren reports grants and personal fees from AstraZeneca and Chiesi, personal fees from Boehringer Ingelheim, Novartis, GSK, MSD, BIAL, Mundipharma and TEVA, and grants from Menarini, outside the submitted work. A. O{\textquoteright}Regan has nothing to disclose. M.W. Pletz has nothing to disclose. C.K. Rhee reports personal fees from MSD, AstraZeneca, GSK Novartis, Takeda, Mundipharma, Boehringer-Ingelheim, Teva, Sanofi and Bayer, outside the submitted work. M.J. Schultz{\textquoteright}s institution and department participated, and participates in, international studies of remdisivir. Participation was without financial compensations, etc., and also did not and will not lead to authorships on manuscripts from these studies. E. Storti has nothing to disclose. C. Strange has nothing to disclose. C.C. Thomson has nothing to disclose. F.J. Torriani has nothing to disclose. X. Wang has nothing to disclose. W. Wuyts has nothing to disclose. T. Xu has nothing to disclose. D. Yang has nothing to disclose. Z. Zhang has nothing to disclose. K.C. Wilson has nothing to disclose. Publisher Copyright: {\textcopyright} ERS 2020.",

year = "2020",

month = sep,

day = "30",

doi = "10.1183/16000617.0287-2020",

language = "English (US)",

volume = "29",

pages = "1--15",

journal = "European Respiratory Review",

issn = "0905-9180",

publisher = "European Respiratory Society",

number = "157",

}

TY - JOUR

T1 - Updated guidance on the management of COVID-19

T2 - From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)

AU - Bai, Chunxue

AU - Chotirmall, Sanjay H.

AU - Rello, Jordi

AU - Alba, George A.

AU - Ginns, Leo C.

AU - Krishnan, Jerry A.

AU - Rogers, Robert

AU - Bendstrup, Elisabeth

AU - Burgel, Pierre Regis

AU - Chalmers, James D.

AU - Chua, Abigail

AU - Crothers, Kristina A.

AU - Duggal, Abhijit

AU - Kim, Yeon Wook

AU - Laffey, John G.

AU - Luna, Carlos M.

AU - Niederman, Michael S.

AU - Raghu, Ganesh

AU - Ramirez, Julio A.

AU - Riera, Jordi

AU - Roca, Oriol

AU - Tamae-Kakazu, Maximiliano

AU - Torres, Antoni

AU - Watkins, Richard R.

AU - Barrecheguren, Miriam

AU - Belliato, Mirko

AU - Chami, Hassan A.

AU - Chen, Rongchang

AU - Cortes-Puentes, Gustavo A.

AU - Delacruz, Charles

AU - Hayes, Margaret M.

AU - Heunks, Leo M.A.

AU - Holets, Steven R.

AU - Hough, Catherine L.

AU - Jagpal, Sugeet

AU - Jeon, Kyeongman

AU - Johkoh, Takeshi

AU - Lee, May M.

AU - Liebler, Janice

AU - McElvaney, Gerry N.

AU - Moskowitz, Ari

AU - Oeckler, Richard A.

AU - Ojanguren, Iñigo

AU - O’regan, Anthony

AU - Pletz, Mathias W.

AU - Rhee, Chin Kook

AU - Schultz, Marcus J.

AU - Storti, Enrico

AU - Strange, Charlie

AU - Thomson, Carey C.

AU - Torriani, Francesca J.

AU - Wang, Xun

AU - Wuyts, Wim

AU - Xu, Tao

AU - Yang, Dawei

AU - Zhang, Ziqiang

AU - Wilson, Kevin C.

N1 - Funding Information: Conflict of interest: C. Bai has nothing to disclose. S.H. Chotirmall has nothing to disclose. J. Rello has nothing to disclose. G.A. Alba has nothing to disclose. L.C. Ginns has nothing to disclose. J.A. Krishnan reports grants from National Institutes of Health, Regeneron/Department of Health and Human Services, and Verily for COVID-19 studies outside the submitted work. R. Rogers has nothing to disclose. E. Bendstrup reports grants and personal fees from Hofmann la Roche and Boehringer Ingelheim, outside the submitted work. P-R. Burgel reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Insmed, Novartis, Pfizer, Teva and Zambon, and grants and personal fees from Vertex and GSK, outside the submitted work. J.D. Chalmers reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Glaxosmithkline, Insmed and Novartis, personal fees from Chiesi and Zambon, and grants from Gilead, outside the submitted work. A. Chua has nothing to disclose. K.A. Crothers has nothing to disclose. A. Duggal has nothing to disclose. Y.W. Kim has nothing to disclose. J.G. Laffey has nothing to disclose. C.M. Luna has nothing to disclose. M.S. Niederman reports other funding from Abbvie and Merck, outside the submitted work. G. Raghu reports consultant fees from Boerhinger Ingelheim, Roche-Genentech, Blade therapeutics, PureTech Health and Humanetics corporation. J.A. Ramirez has nothing to disclose. J. Riera has nothing to disclose. O. Roca provides consultancy to Hamilton Medical but did not receive any personal fees. All compensations were received by the Institute of Research of his institution. He also reports personal fees from Air Liquide, outside the submitted work. M. Tamae-Kakazu has nothing to disclose. A. Torres has nothing to disclose. R.R. Watkins has nothing to disclose. M. Barrecheguren reports speaker fees from Grifols, Menarini, CSL Behring, Boehringer Ingelheim and GSK, and consulting fees from GSK and Novartis, outside the submitted work. M. Belliato has nothing to disclose. H.A. Chami reports grants, personal fees and non-financial support from Pfizer, and personal fees from Boehringer Ingelheim, MSD, Novartis, Mundipharma and AstraZeneca, outside the submitted work. R. Chen has nothing to disclose. G.A. Cortes Puentes has nothing to disclose. C. Delacruz has nothing to disclose. M.M. Hayes has nothing to disclose. L.M.A. Heunks reports grants from Liberate medical, USA, personal fees from Getinge Critical Care, Sweden, and grants and personal fees from Orion Pharma, Finland, outside the submitted work. S.R. Holets has nothing to disclose. C.L. Hough has nothing to disclose. S. Jagpal was a sub-investigator for the RWJ New Brunswick Remdesivir study. S. Jeon has nothing to disclose. K. Johkoh has nothing to disclose. M.M. Lee has nothing to disclose. J. Liebler has nothing to disclose. G.N. McElvaney has nothing to disclose. A. Moskowitz has nothing to disclose. R.A. Oeckler has nothing to disclose. I. Ojanguren reports grants and personal fees from AstraZeneca and Chiesi, personal fees from Boehringer Ingelheim, Novartis, GSK, MSD, BIAL, Mundipharma and TEVA, and grants from Menarini, outside the submitted work. A. O’Regan has nothing to disclose. M.W. Pletz has nothing to disclose. C.K. Rhee reports personal fees from MSD, AstraZeneca, GSK Novartis, Takeda, Mundipharma, Boehringer-Ingelheim, Teva, Sanofi and Bayer, outside the submitted work. M.J. Schultz’s institution and department participated, and participates in, international studies of remdisivir. Participation was without financial compensations, etc., and also did not and will not lead to authorships on manuscripts from these studies. E. Storti has nothing to disclose. C. Strange has nothing to disclose. C.C. Thomson has nothing to disclose. F.J. Torriani has nothing to disclose. X. Wang has nothing to disclose. W. Wuyts has nothing to disclose. T. Xu has nothing to disclose. D. Yang has nothing to disclose. Z. Zhang has nothing to disclose. K.C. Wilson has nothing to disclose. Publisher Copyright: © ERS 2020.

PY - 2020/9/30

Y1 - 2020/9/30

N2 - Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.

AB - Background: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. Methods: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. Results: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. Conclusions: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.

UR - http://www.scopus.com/inward/record.url?scp=85092418767&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85092418767&partnerID=8YFLogxK

U2 - 10.1183/16000617.0287-2020

DO - 10.1183/16000617.0287-2020

M3 - Review article

C2 - 33020069

AN - SCOPUS:85092418767

SN - 0905-9180

VL - 29

SP - 1

EP - 15

JO - European Respiratory Review

JF - European Respiratory Review

IS - 157

M1 - 200287

ER -

Updated guidance on the management of COVID-19: From an american thoracic society/european respiratory society coordinated international task force (29 July 2020)

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