This document is the update of an interim guidance originally published under the title “ Clinical management of COVID-19: interim guidance, 27 May 2020".
Providing trustworthy guidance that is comprehensive and holistic for the optimal care of COVID-19 patients, throughout their entire illness is necessary. The previous version of the Clinical management of COVID-19 provided recommendations that can be applied when caring for patients during the COVID-19 care pathway. This guideline now also includes Best Practice Statement on caring for COVID-19 patients after their acute illness and 5 new recommendations:
- A conditional recommendation to use clinical judgment, including consideration of patients’ values and preferences and local and national policy if available, to guide management decisions including admission to hospital and to the intensive care unit (ICU), rather than currently available prediction models for prognosis (very low certainty).
- A conditional recommendation for use of pulse oximetry monitoring at home as part of a package of care, including patient and provider education and appropriate follow-up in symptomatic patients with COVID-19 and risk factors for progression to severe disease who are not hospitalized (very low certainty).
- A conditional recommendation for the use of awake prone positioning in patients with severe COVID-19 that are hospitalized requiring supplemental oxygen or non-invasive ventilation (low certainty).
- A conditional recommendation to use thromboprophylaxis dosing of anticoagulation rather than intermediate or therapeutic dosing in patients hospitalized with COVID-19, without an established indication for higher dose of anticoagulation (very low certainty).
- A conditional recommendation for the use of existing care bundles (defined as three or more evidence-informed practices delivered together and consistently to improve care) chosen locally by hospital or ICU and adapted as necessary for local circumstances in patients with critical COVID-19 (very low certainty).
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