A living WHO guideline on drugs for COVID-19

This living guideline responds to emerging evidence from randomised controlled trials (RCTs) on existing and new drug treatments for covid-19. More than 2800 trials on covid-19 interventions have been registered or are ongoing. Among these are large national and international platform trials (such as RECOVERY, WHO SOLIDARITY, and DISCOVERY) that recruit large numbers of patients, with a pragmatic and adaptive design. These platform trials are currently investigating and reporting on drugs such as antiviral monoclonal antibodies and immunomodulators. This rapidly evolving evidence landscape requires trustworthy interpretation and expeditious clinical practice guidelines to inform clinicians, patients, governments, ministries, and health administrators.

Home Based Isolation and Care Guidelines for Patients with COVID-19

Patients who are assessed by a Health Care Worker and meet all the criteria below will be considered for home-based isolation and care:

  • Laboratory confirmed COVID-19
  • Asymptomatic patients or patients with mild symptoms of COVID-19
  • Absence of comorbidities
  • Access to a suitable space for home-based isolation and care

Giving Oxygen to COVID-19 Patients in Kenya

As the COVID‐19 pandemic continues to unfold here in Kenya, more and more patients are requiring oxygen. To increase the capacity of healthcare facilities to provide oxygen to more patients, we have installed Oxygen Gas Manifolds in the emergency departments at the county referral hospitals in Machakos, Kiambu (COVID-19 isolation centre) and Kajiado counties and at the Alupe Sub-County Hospital COVID-19 isolation centre in Busia county. These are the hardest hit counties at the moment and we continue to seek additional support to support more facilities.

The Recovery Trial: Effect of Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report

The findings of this well done randomized controlled trial indicate that in patients with COVID-19 pneumonia, that dexamethasone improves 28d mortality compared to placebo in patients requiring invasive mechanical ventilation (IMV) (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).  There was no benefit to patients not requiring oxygenation support and even a signal for harm.  It is important to remember this is a preprint, preliminary report, which is better than a press release. At this time, in patients requiring any oxygen therapy, HFNC, NIV, IMV, or ECMO I would recommend dexamethasone until further evidence disproves this benefit.

COVID-19 Rx: Treatment Simulations

You are a health care provider in a developed country. Several patients await your care. These patients are suspected of having COVID-19 and have been triaged by severity of illness. We recommend starting with the mildly ill patient, but you are free to see them in any order.