[Clinical practice guideline: tocilizumab for patients with severe and critical COVID-19].

{"article_title":"[Clinical practice guideline: tocilizumab for patients with severe and critical COVID-19].","author":"Ragusa MA, Tortosa F, Carrasco G, Montero G, Haluska P, Lamfre L, Izcovich A","journal_title":"Medicina","issn":"1669-9106","isbn":"","publication_date":"2021 May","volume":"81","issue":"6","first_page":"1015","page_count":"","accession_number":"34875602","doi":"","publisher":"Fundacio\u0301n Revista Medicina (Buenos Aires)","doctype":"Journal Article","subjects":"COVID-19 Drug Treatment; Adult; Antibodies, Monoclonal, Humanized; Humans; Oxygen Saturation; Respiration, Artificial; SARS-CoV-2; Societies, Medical","interest_area":["Infectious Disease & Vaccines"," Emergency Medicine"," Internal Medicine"],"abstract":"In COVID-19, there are states of hyperinflammation in severely or critically ill people, where immunosuppression and blocking of IL-6 receptors could be beneficial. Faced with this situation, with the support of a methods group using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, about the use of tocilizumab for patients with severe and critical illness coronavirus. This guide focuses on making recommendations for the use of tocilizumab in patients with severe and critical COVID-19. This clinical practice guideline was prepared following the WHO guideline development methods. A multidisciplinary development group was formed, with clinical and health policy experts, methodologists and users. Panel and methods group members signed a declaration of conflict of interest. We searched the Epistemonikos Foundation's LOVE database for randomized studies up to April 17, 2021. The synthesis and evidence profiles were prepared using the GRADE approach and an economic model was developed. Among hospitalized adults with progressive severe or critical COVID-19, the guideline panel su ggests tocilizumab. (Conditional recommendation, Moderate certainty of evidence) Implementation considerations. A. Dose: 8 mg\/kg of actual weight, single-dose, intravenously), maximum dose 800 mg; B. Administer dexamethasone 8 mg (or equivalent) for 10 days together with tocilizumab; C. The recommendation applies to: 1. patients with severe disease defined as SpO2 = 92% with room air and\/or patients receiving supplemental oxygen (including a high-flow nasal cannula and non-invasive ventilation); 2. critically ill patients: requiring invasive mechanical ventilation.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=34875602&authtype=shib&custid=ns346513&group=main&profile=eds","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Ragusa MA, Tortosa F, Carrasco G, Montero G, Haluska P, Lamfre L, Izcovich A","Journal_Info":"Publisher: Fundacio\u0301n Revista Medicina (Buenos Aires) Country of Publication: Argentina NLM ID: 0204271 Publication Model: Print Cited Medium: Internet ISSN: 1669-9106 (Electronic) Linking ISSN: 00257680 NLM ISO Abbreviation: Medicina (B Aires) Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline","Published_Date":"2021-01-01","Source":"Medicina [Medicina (B Aires)] 2021; Vol. 81 (6), pp. 1015-1035.","Languages":"Spanish; Castilian","Electronic_ISSN":"1669-9106","MeSH_Terms":"COVID-19 Drug Treatment*, Adult ; Antibodies, Monoclonal, Humanized ; Humans ; Oxygen Saturation ; Respiration, Artificial ; SARS-CoV-2 ; Societies, Medical","Subjects":"Adult, Antibodies, Monoclonal, Humanized, Humans, Oxygen Saturation, Respiration, Artificial, SARS-CoV-2, Societies, Medical, COVID-19 Drug Treatment","Title_Abbreviations":"Medicina","Volume":"81"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"34875602","RelevancyScore":"880","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"879.679443359375"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34875602&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=34875602&authtype=shib&custid=ns346513&group=main&profile=eds"}