Abstract

Introduction: In the absence of high-quality evidence for Coronavirus disease-2019 (COVID-19), supportive care is advocated during this pandemic. We aim to develop a consensus statement from global experts for pharmacological management, based on the pathophysiology of COVID-19. Material and Methods: We used a modified Delphi methodology in three steps: 1) Formulation of the steering committee and questionnaire; 2) Delphi methodology and selection of experts; 3) Final meeting of the steering committee and analysis, discussion, preparation, and presentation of captured data. Results: 34 (73·9%) experts accepted the invitation for the study. We conducted two rounds of Delphi and consensus (>70% votes) was achieved on 11 out of 24 statements after the end of round two. Conclusion: This global consensus suggests that “Anti-viral therapy should be administered in the early infection phase of COVID-19 followed by low dose steroid therapy in pulmonary phase. Prophylactic dose anticoagulation should be used in hospitalized, mild to moderate COVID-19 patients. We make no suggestions for the use of immune modulation therapy”.

Highlights

  • In the absence of high-quality evidence for Coronavirus disease-2019 (COVID-19), supportive care is advocated during this pandemic

  • Step-1: Formation of the steering committee, literature review, and preparation of focused questionnaire: Seven critical care physicians who are currently managing of COVID-19 formed a steering committee

  • Consensus Statement: The global consensus states that “anti-viral therapy should be given in the early infection phase of COVID19 followed by low-dose steroid therapy in the pulmonary phase

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Summary

Introduction

In the absence of high-quality evidence for Coronavirus disease-2019 (COVID-19), supportive care is advocated during this pandemic. We aim to develop a consensus statement from global experts for pharmacological management, based on the pathophysiology of COVID-19. Conclusion: This global consensus suggests that "Anti-viral therapy should be administered in the early infection phase of COVID-19 followed by low dose steroid therapy in pulmonary phase. Ill COVID-19 patients have unusually high mortality rates, leaving the clinician with a short window of opportunity to act [1,2]. There is a paucity on a global consensus for a pragmatic pharmacological management protocol. We brought together global experts and developed a consensus view that would act as an interim guide for managing COVID-19 patients until ongoing research studies provide more definitive evidence

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