Browsing by Author "Power, Nicholas"

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    European Society of Clinical Microbiology and Infectious Diseases Guidelines for Coronavirus Disease 2019: An Update on Treatment of Patients with Mild/Moderate Disease
    (2022) Bartoletti, Michele; Azap, Ozlem; Barac, Aleksandra; Bussini, Linda; Ergonul, Onder; Krause, Robert; Martin-Quiros, Alejandro; Pano-Pardo, Jose Ramon; Power, Nicholas; Sibani, Marcella; Szabo, Balint Gergely; Tsiodras, Sotirios; Zollner-Schwetz, Ines; Rodriguez-Bano, Jesus; 36028088
    Scope: Despite the large availability of vaccines, coronavirus disease 2019 (COVID-19), induced by severe acute respiratory syndrome coronavirus 2, continues to be a major threat for health-care providers and fragile people. A number of options are now available for outpatients with mild-to-moderate COVID-19 at the risk of disease progression for the prevention of deaths or hospitalization. Methods: A European Society of Clinical Microbiology and Infectious Diseases COVID-19 guidelines task force was established by the European Society of Clinical Microbiology and Infectious Diseases Executive Committee. A small group was established, half appointed by the chair and the remaining selected based on an open call. Each panel met virtually once a week. For all decisions, a simple majority vote was used. A long list of clinical questions using the population, intervention, comparison, outcome format was developed at the beginning of the process. For each population, intervention, comparison, outcome, two panel members performed a literature search, with a third panelist involved in case of inconsistent results. Voting was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Recommendations: In this update, we focus on anti-viral agents, monoclonal antibodies (mAbs) and other treatment options proposed for patients with mild or moderate COVID-19 who are at the risk of hospitalization or death. Although the use of anti-virals is recommended, especially nirmatrelvir/ritonavir and remdesivir or, alternatively, molnupirarvir, the administration of mAbs against the spike protein strictly depends on circulating variants or the ability to test timely for variants and sub-variants. At the time of writing (AprileJune 2022), the only active mAb was tixagevimab/cilgavimab given the predominance of the Omicron BA.2, BA.3, BA.4 and BA.5 sub-lineages in Europe. However, considering that the epidemiological scenario is extremely dynamic, constant monitoring of variants of concern is mandatory. Michele Bartoletti, Clin Microbiol Infect 2022;28:1578