Arnav Agarwal Profile picture
Internal Medicine physician. @UofTMedicine 》@McMasterGIM @MacDeptMed. ★ Evidence synthesis • guideline development • advocacy • editor @HealthyDebate.

Dec 7, 2021, 9 tweets

🔊Our latest @WHO living guidance on treatments for #COVID19, out today:

For severe/critical:
✅steroids
✅IL-6 RB
🟨mAb
🟧convalescent plasma🔥

For non-severe:
🟨mAb
🟧steroids
🚫convalescent plasma🔥

For both:
🟧remdesivir
🟧ivermectin
🚫HCQ
🚫LPV/r

bit.ly/3pAK6Oe

Two recommendations:
🌟against administering convalescent plasma for non-severe covid-19.
🌟against administering convalescent plasma for severe or critical covid-19, except in the context of a clinical trial.

A living systematic review & network meta-analysis, led by @RSiemieniuk & @rominabrigpet with contributions from @jessbartoszko, @DenaZera, @AnilaQasim, @Elena_Kum et al, informed recommendations.

Now with a 🔥🔥 website with evidence readily accessible: covid19lnma.com.

🌟For non-severe illness:
- No benefit for critical or important outcomes, including mortality and mechanical ventilation
- Potential for harm
- Resource requirements / practical issues (donor identification & testing, plasma collection / storage / transportation, administration)

🌟For severe/critical illness:
- Low certainty evidence for mortality, mechanical ventilation, etc.
- Potential for harm.
- Resource requirements (similar issues, though may be easier to administer in hospitalized patients).
- More research needed to reduce uncertainty.

This work contributes to collaborative living guidance produced by @WHO and the #MAGIC Evidence Ecosystem on drugs to prevent #COVID19, also published via @bmj_latest.

This is an incredible cross-collaborative effort - honoured and lucky to be part of it.

Associated guideline in the @WHO portal: bit.ly/3ExWeG3

Associated guideline in @theMAGICapp:
bit.ly/3Gk5ldZ

Associated LNMA: bit.ly/3lIKNnP

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