たまには合衆国のガイドラインも紹介
別に変わったことは言ってないのだが、軽症者に「よく効く薬」だと投与して、死亡率を12倍に上昇させるような「ヒト対象非臨床試験」が行われているような国もあるので、。
●酸素の必要のない軽症者には薬は要らない。なぜならほとんどが自然軽快する軽症患者を薬のリスクに晒してはならないから。特にデキサメタゾンは軽症者に投与すると死亡率が上昇する可能性が示されているので（Recovery Trialの図）投与してはならない。
●中等症に対してはレムデシビル単独かあるいはデキサメタゾンの併用
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NIH Updates COVID-19 Treatment Guidelines PHYSICIAN'S FIRST WATCH for October 12, 2020
The National Institutes of Health has updated its guidelines on treating COVID-19. Here's a look at what's new:
-- Treatment recommendations are outlined according to the severity of disease. For example, for COVID-19 patients who are not hospitalized or who are hospitalized but not on supplemental oxygen, no particular antiviral or immunomodulatory treatment is recommended, and the panel recommends against using dexamethasone. For hospitalized patients on oxygen (but without needing a high-flow device or mechanical ventilation), remdesivir alone or with dexamethasone is advised.
-- Increasing evidence points to persistent symptoms after COVID-19 recovery -- including headache, vision and hearing changes, loss of taste or smell, memory loss, and cognitive impairment for up to 3 months -- but effective management strategies have not been identified. This may occur even in patients with mild COVID-19. (Related to this, see the New York Times story linked below on persistent "brain fog" in COVID-19 survivors.)
-- Sections have been added on managing COVID-19 in HIV-infected patients, as well as on sedation management and post-intensive care syndrome in ICU patients.See the full guidelines at the first link
Link(s):
Full treatment guidelines (Free PDF)
Guideline updates (Free)
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→The RECOVERY Collaborative Group.Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report. N Engl J Med. 2020 Jul 17;NEJMoa2021436. doi: 10.1056/NEJMoa2021436
→「アビガンは毒薬」を立証した「観察研究」
→コロナのデマに飽きた人へ