RT Journal Article SR Electronic T1 COVID-19 Therapies for inpatients: a review and quality assessment of clinical guidelines JF ERJ Open Research JO erjor FD European Respiratory Society SP 00236-2022 DO 10.1183/23120541.00236-2022 A1 David A. Wohl A1 Aprille A. Espinueva A1 Lauren Dau A1 Chen-Yu Wang A1 Alexandra Lachmann A1 Rujuta A. Bam A1 Aaditya Rawal A1 Kerris Chappell-Smith A1 Juergen K. Rockstroh YR 2022 UL http://openres.ersjournals.com/content/early/2022/08/24/23120541.00236-2022.abstract AB Due to condensed development processes, expanding evidence and differences in healthcare system characteristics, many COVID-19 guidelines differ in their quality and treatment recommendations, which has consequences for clinical practice. This review aimed to identify COVID-19 treatment guidelines, assess their quality, and summarise their recommendations. Guidelines were identified for five therapies most commonly used among inpatients with COVID-19 (remdesivir, dexamethasone, tocilizumab, baricitinib, and casirivimab/imdevimab) from 11 countries. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. Full details of recommendations and supporting evidence were analysed for high-quality guidelines, defined as those scoring ≥50% in Domain 3 (Rigour of Development) of AGREE-II. Overall, guidelines differed substantially in their quality and, even among high-quality guidelines using the same evidence, recommendations regarding specific therapeutics varied. Potential reasons for this heterogeneity, including the availability and consistency of clinical data, visibility of trial endpoints, and context-specific factors, are discussed.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Authors’ Contributions: Substantial contributions to study conception and design: DAW; AAE; LD; CYW; AL; RAB; AR; JKR; substantial contributions to analysis and interpretation of the data: DAW; AAE; LD; CYW; AL; RAB; AR; KCS; JKR; drafting the article or revising it critically for important intellectual content: DAW; AAE; LD; CYW; AL; RAB; AR; KCS; JKR; final approval of the version of the article to be published: DAW; AAE; LD; CYW; AL; RAB; AR; KCS; JKR.Conflicts of Interest: Chen-Yu Wang received support for the present manuscript from Gilead Sciences, for which they are an employee; stock or stock options owned for Gilead Sciences.Conflicts of Interest: David Alain Wohl received support for the present manuscript from Gilead Sciences; the following relationships have been disclosed outside the submitted work; grants or contracts received from Gilead Sciences, Eli Lilly and Merck & Co; honoraria received for educational activities from Gilead Sciences.Conflicts of Interest: Jürgen Rockstroh reports the following relationships outside the submitted work; consulting fees from Gilead, Janssen, Merck and ViiV; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events for Gilead, Janssen, Merck, Theratechnologies and ViiV; participation on a Data Safety Monitoring Board or Advisory Board for Abivax, Glapagos, Gilead, Merck and ViiV.Conflicts of Interest: Kerris Chappell-Smith received support for the present manuscript from Costello Medical.Conflicts of Interest: Rujuta A Bam (Rujuta N Phadke) received support for the present manuscript from Gilead Sciences, for which they are an employee; stock or stock options owned for Gilead Sciences.Conflicts of Interest: The remaining authors have nothing to disclose.