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Colegio de Medicina Interna de México.

2020, Número 4

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Med Int Mex 2020; 36 (4)


Guías de tratamiento para los pacientes infectados con COVID-19

Alva-Díaz C, Velásquez-Rimachi V, Morán-Mariños C, Osores-Flores M, Chachaima-Mar J, Huerta-Rosario A, Molina RA, Rivera-Torrejón O, Pinedo-Torres I, Verona-Mesia B, Huerta-Rosario M, Pacheco-Barrios K, Metcalf T

Idioma: Español
Referencias bibliográficas: 90
Paginas: 509-529
Archivo PDF: 306.68 Kb.


RESUMEN

Antecedentes: La nueva información de terapias contra el SARS-CoV-2 crece rápidamente. Como resultado, los países y organizaciones han comenzado a publicar pautas terapéuticas.
Objetivo: Proporcionar una sinopsis de las recomendaciones soportadas en guías basadas en evidencia de las opciones terapéuticas con actividad potencial contra el SARS-CoV-2.
Método Revisión sistemática rápida de guías o protocolos que dan orientación clínica provisional para la enfermedad COVID-19 de PubMed/Medline, Web Of Science, Scopus, Scielo, Google Scholar y una búsqueda general en Google. Los duplicados se eliminaron y se incluyó un resumen de las intervenciones propuestas. Luego se realizó un análisis de riesgos y beneficios.
Resultados: Veinte guías o protocolos se seleccionaron, la mayor parte provino de Europa y Latinoamérica. Diecisiete intervenciones se identificaron y clasificaron en seis grupos farmacológicos. Los antimaláricos, lopinavir/ritonavir y remdesivir fueron los únicos agentes recomendados y respaldados por ensayos clínicos. Las intervenciones restantes se recomendaron con base en evidencia indirecta, estudios observacionales o estudios in vitro.
Conclusiones: Los antimaláricos han mostrado resultados contra COVID-19 con desenlaces sustitutos y eventos adversos graves. Recomendamos la vigilancia activa de agentes con eficacia potencial contra el SARS-CoV-2 incorporando los resultados en las guías y protocolos nacionales. Deben realizarse ensayos clínicos que muestren un beneficio directo con desenlaces clínicamente relevantes en diversas poblaciones.


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