The National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel released its final set of recommendations on Feb. 29, 2024. An article in the Annals of Internal Medicine includes a copy of the final guidelines and incorporates perspectives and lessons learned as the public health emergency ended. Convened in March 2020 at the request of the U.S. Department of Health and Human Services, the expert panel developed "living" guidelines, that were continuously updated as new data emerged and designed to be accessible to clinicians. Over the past four years, the panel provided treatment strategies for COVID-19 using FDA-approved and -authorized antiviral therapies and immunomodulators. Further recommendations will now transition to professional societies.
According to the Panel, the final guidelines benefitted from the availability of 4 FDA-approved drugs for the treatment of COVID-19 as well as numerous well-conducted clinical trials that demonstrated the value of antiviral drugs, immunomodulators and other interventions and the lack of benefit of several other purported therapies that were promoted. The Panel’s treatment recommendations were organized by disease severity and were divided into nonhospitalized and hospitalized patient categories. For nonhospitalized patients the guidelines recommend early symptom management and antiviral use, especially in patients at high risk for progression to severe disease. For hospitalized patients, treatment to prevent further disease progression focuses on early intervention with remdesivir and treatment with dexamethasone, if needed. The Panel also recommended controlling inflammation and preventing blood clots with blood thinners in those not at increased risk for bleeding.
Included in this article is a summary of lessons learned during the pandemic. These lessons informed the guidelines, which were developed in full transparency to ensure credibility and objectivity. According to the panel, these guidelines and the processes used to develop them should give professional societies a template they can follow when managing public health emergencies or pandemics in the future.
Source: American College of Physicians (ACP)