The final guidelines provide insight into lessons learned for developing clinical guidelines in future emergency situations.

RT’s Three Key Takeaways:

1. Final COVID-19 Treatment Recommendations: The NIH panel’s guidelines focus on the use of FDA-approved antiviral therapies and immunomodulators, recommending early intervention for both nonhospitalized and hospitalized COVID-19 patients.
2. Lessons Learned: The article includes insights gained during the pandemic, offering professional societies a framework to follow when managing future public health emergencies.
3. Transition to Professional Societies: With the public health emergency concluded, future updates to COVID-19 treatment recommendations will transition to professional medical societies.

The National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel, which released its final set of recommendations for treating COVID-19 on Feb 29, has published an article with a copy of the final guidelines, as well as perspectives and lessons learned as the public health emergency ended. 

Convened in March 2020 at the request of the US Department of Health and Human Services, the expert panel developed “living” guidelines, that were continuously updated as new data emerged and designed to be accessible to clinicians. 

Over the past four years, the panel provided treatment strategies for COVID-19 using US Food and Drug Administration (FDA)-approved and -authorized antiviral therapies and immunomodulators. 

Further recommendations will now transition to professional societies. The details are published in Annals of Internal Medicine.

Key Therapies and Future Framework

According to the panel, the final guidelines benefitted from the availability of four FDA-approved drugs for the treatment of COVID-19 as well as numerous well-conducted clinical trials that demonstrated the value of antiviral drugs, immunomodulators, and other interventions and the lack of benefit of several other purported therapies that were promoted. 

The panel’s treatment recommendations were organized by disease severity and were divided into nonhospitalized and hospitalized patient categories. For nonhospitalized patients the guidelines recommend early symptom management and antiviral use, especially in patients at high risk for progression to severe disease. For hospitalized patients, treatment to prevent further disease progression focuses on early intervention with remdesivir and treatment with dexamethasone, if needed. 

The panel also recommended controlling inflammation and preventing blood clots with blood thinners in those not at increased risk for bleeding.

Included in this article is a summary of lessons learned during the pandemic. These lessons informed the guidelines, which were developed with transparency to ensure credibility and objectivity. According to the panel, these guidelines and the processes used to develop them should give professional societies a template they can follow when managing public health emergencies or pandemics in the future.

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