2026-05-21T23:54:31Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/181202024-11-28T14:48:32Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16927

00925njm 22002777a 4500 dc Pérez-Belmonte, Luis M. author López-Carmona, María D. author Quevedo-Marín, Juan L. author Ricci, Michele author Martín-Carmona, Jesica author Sanz-Cánovas, Jaime author López-Sampalo, Almudena author Martín-Escalante, María D. author Bernal-López, M. Rosa author Gómez-Huelgas, Ricardo author 2020-09-19 Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence. 10.3390/ijerph17186845 1660-4601 International Journal of Environmental Research and Public Health http://hdl.handle.net/10668/3370 32961675 http://hdl.handle.net/20.500.12105/18120 Coronavirus disease 2019 Management Clinical protocol Differences Antiviral agent Corticosteroids Anakinra Heparin Infecciones por coronavirus Corticosteroides Andalusia Antivirales Protocolos Clínicos Heparina Proteína Antagonista del Receptor de Interleucina 1 Andalucía Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain