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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for
...
hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
more
UNAIDS and the World Health Organization have published this updated guidance on ethical considerations in HIV prevention trials. The new guidance is the result of a year-long process that saw more than 80 experts and members of the public give inpu
...
ts and is published 21 years after the first edition appeared.
more
The publication is designed to provide Ipas staff, trainers, partners and other health-care providers with access to up-to-date, evidence-based recommendations. In general, the recommendations are the same as those in the World Health Organization’s 2012 Safe Abortion: Technical and Policy Guidanc
...
e for Health Systems, Second edition. In rare cases, the recommendations have been modified due to the settings where Ipas works. In addition, if there is more current evidence to inform the recommendations, they will be updated here.
more
This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analy
...
sis, and Phase IV studies. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
more
Optimizing Clinical Trial Design to Maximize Evidence Generation in Pediatric HIV
D. Ford; R. Turner; A. Turkova; et al.
JAIDS Journal of Acquired Immune Deficiency Syndromes; Ovid
(2018)
C2
Supplement Article
www.jaids.com J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018
Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.
The Solidarity Trial will compare four treatment options against standard of care, to asses
...
s their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
Until there is sufficient evidence, WHO cautions against physicians and medical associations recommending or administering these unproven treatments to patients with COVID-19 or people self-medicating with them. WHO is concerned by reports of individuals self-medicating with chloroquine and causing themselves serious harm.
more
26 March 2021 Slideset updated regularly to include the latest data on the evolution and duration of COVID-19 symptoms and prevalence and duration of natural immunity.
Introduction
Chapter A.3
The 7th edition of the Orange Guide provides practical guidance to health workers on the front line of TB control. It includes sections on HIV, MDR-TB and a review of the recommended treatment regimens
Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America
John R. Perfect, William E. Dismukes, Francoise Dromer, et al.
Infectious Diseases Society of America
(2010)
Clinical Infectious Diseases 2010; 50:291–322
J Hepatol (2017), http://dx.doi.org/10.1016/j.jhep.2017.03.021
The use of Delamanid and Bedaquiline for Children with Drug-Resistant Tuberculosis.
First published in 2020, this toolkit is intended for clinicians working in acute care, managing adult and paediatric patients with acute respiratory infection, including severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock. The main objective is to provide key tools for us
...
e in the care of critically ill patients – from hospital entry to hospital discharge.
The 2022 updated version includes new tools and adapted algorithms, checklists, memory aids for COVID-19 and influenza, and the latest clinical evidence regarding clinical management of SARI. It is intended to help clinicians care for SARI patients: from epidemiology of severe acute respiratory infections, screening and triage, infection prevention and control, monitoring of patients, laboratory diagnosis, principles of oxygen therapy and different types of ventilation (invasive and non-invasive), as well as antimicrobial and immunomodulator therapies, to ethical and quality of care assessments.
The first edition is availbel in Ukrainian and Russian
more
Interim rapid response guidance, 10 June 2022.
It includes considerations for certain populations such as patients with mild disease with considerations for community care, patients with moderate to severe disease, sexually active persons, pregnant or breastfeeding women, children and young persons
...
. The guidance also addresses considerations for clinical management such as the use of therapeutics, nutritional support, mental health services, and post-infection follow-up.
The document provides guidance for clinicians, health facility managers, health workers and infection prevention and control practitioners including but not limited to those working in primary care clinics, sexual health clinics, emergency departments, infectious diseases clinics, genitourinary clinics, dermatology clinics, maternity services, paediatrics, obstetrics and gynaecology and acute care facilities that provide care for patients with suspected or confirmed monkeypox
more
Update, 23 de junio de 2022
