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Dtsch Arztebl Int ; 119(19): 342-349, 2022 May 13.
Article in English | MEDLINE | ID: covidwho-2002483


BACKGROUND: One of the purposes of outpatient treatment for COVID-19 patients is to prevent severe disease courses and hospitalization. There is a need for evidence-based recommendations to be applied in primary care and specialized outpatient settings. METHODS: This guideline was developed on the basis of publications that were retrieved by a systematic search for randomized controlled trials in the Cochrane COVID-19 trial registry. The quality of evidence was assessed with GRADE, and structured consensus generation was carried out with MAGICapp. RESULTS: Unvaccinated COVID-19 outpatients with at least one risk factor for a severe disease course may be treated in the early phase of the disease with sotrovimab, remdesivir, or nirmatrelvir/ritonavir. Molnupiravir may also be used for such patients if no other clinically appropriate treatment options are available. Immunosuppressed persons with COVID-19 who are at high risk, and whose response to vaccination is expected to be reduced, ought to be treated with sotrovimab. It should be noted, however, that the clinical efficacy of sotrovimab against infections with the omicron subtype BA.2 is uncertain at the currently used dose, as the drug has displayed reduced activity against this subtype in vitro. COVID-19 patients at risk of a severe course may be offered budesonide inhalation, according to an off-label recommendation of the German College of General Practitioners and Family Physicians (other medical societies do not recommend either for or against this treatment). Thrombo - embolism prophylaxis with low-molecular-weight heparin may be given to elderly patients or those with a pre-existing illness. No recommendation is made concerning fluvoxamine or colchicine. Acetylsalicylic acid, azithromycin, ivermectin, systemic steroids, and vitamin D should not be used for the outpatient treatment of COVID-19. CONCLUSION: Drug treatment is now available for outpatients with COVID-19 in the early phase. Nearly all of the relevant trials have been conducted in unvaccinated subjects; this needs to be kept in mind in patient selection.

COVID-19 , Aged , Antibodies, Monoclonal, Humanized , Antibodies, Neutralizing , COVID-19/drug therapy , Humans , Outpatients , Randomized Controlled Trials as Topic , SARS-CoV-2 , Treatment Outcome
Z. ; 6(96): 257-260, 2020.
Article in German | WHO COVID, ELSEVIER | ID: covidwho-667853


Since the United Kingdom has been severly hit by the corona virus pandemic, a renowned epidemiologist, together with 26 colleagues has made a proposal how to lead the way out of the crisis: They suggested to make a weekly PCR-test on the whole British population. This paper was set out to analyse the pro-cedural and economic risks and opportunities of this idea.

Z. ; 5(96): 230-234, 2020.
Article in German | WHO COVID, ELSEVIER | ID: covidwho-360996


Assays to test for antibodies against SARS-CoV-2 can display a high proportion of false-positive results if the frequency of the disease in the general population is low. Testing is not suitable for proving or ruling out an acute infection. Judging an individual patient, a positive antibody titer does not necessarily mean that this person is immune. Currently ELISA assays are not appropriate for individual screening purposes but possibly can complement diagnostic procedures. They are suitable for population-based screening in the context of studies.