Evidence map›Paper›PMID 33377451›Full record

ReviewThe American journal of tropical medicine and hygiene2020

Pragmatic Recommendations for Therapeutics of Hospitalized COVID-19 Patients in Low- and Middle-Income Countries.

Varun U Shetty, Brian Jason Brotherton, Andrew Achilleos, Kevan M Akrami, Lia M Barros, William Checkley, Natalie Cobb, Stephanie Maximous, David Misango, Casey Park and 3 more

Abstract readReview
In one paragraph

Review in The American journal of tropical medicine and hygiene, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Varun U Shetty1Critical Care Medicine Department, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Brian Jason Brotherton1Critical Care Medicine Department, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Andrew Achilleos3Department of Critical Care, Sunnybrook Health Sciences Center, Toronto, Canada.
Kevan M Akrami4Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
Lia M Barros7Department of Cardiology, University of Washington Medical Center, Seattle, Washington.
William Checkley8Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Natalie Cobb10Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington Medical Center, Seattle, Washington.
Stephanie Maximous11Division of Pulmonary Allergy Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
David Misango12Department of Anaesthesiology and Critical Care Medicine, Aga Khan University Hospital, Nairobi, Kenya.
Casey Park13Department of Medicine, Interdepartmental Division of Critical Care Medicine, Toronto, Canada.
Shaurya Taran13Department of Medicine, Interdepartmental Division of Critical Care Medicine, Toronto, Canada.
Burton W Lee11Division of Pulmonary Allergy Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The therapeutic options for COVID-19 patients are currently limited, but numerous randomized controlled trials are being completed, and many are on the way. For COVID-19 patients in low- and middle-income countries (LMICs), we recommend against using remdesivir outside of a clinical trial. We recommend against using hydroxychloroquine ± azithromycin or lopinavir-ritonavir. We suggest empiric antimicrobial treatment for likely coinfecting pathogens if an alternative infectious cause is likely. We suggest close monitoring without additional empiric antimicrobials if there are no clinical or laboratory signs of other infections. We recommend using oral or intravenous low-dose dexamethasone in adults with COVID-19 disease who require oxygen or mechanical ventilation. We recommend against using dexamethasone in patients with COVID-19 who do not require supplemental oxygen. We recommend using alternate equivalent doses of steroids in the event that dexamethasone is unavailable. We also recommend using low-dose corticosteroids in patients with refractory shock requiring vasopressor support. We recommend against the use of convalescent plasma and interleukin-6 inhibitors, such as tocilizumab, for the treatment of COVID-19 in LMICs outside of clinical trials.

Indexed as

COVID-19 Drug TreatmentDeveloping CountriesCOVID-19HospitalizationHumansInpatientsPatient CarePractice Guidelines as TopicSARS-CoV-2

Identifiers

PMID33377451
PMCPMC7957231

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.