BACKGROUND: New information for potential treatments against SARS-CoV-2 is rapidly increasing. As a result, countries and organizations have begun to release therapeutic guidelines. OBJECTIVE: To provide a synopsis of the recommendations supported in evidence-based guidelines for therapeutic options with potential activity against SARS-CoV-2. METHOD: Rapid systematic review of guidelines and/or protocols that provide interim clinical guidance for COVID-19 disease were extracted from PubMed/Medline, Web of Science, Scopus, Scielo, Google Scholar, and a general Google search. Duplicates were removed and a summary of the proposed interventions was included. A benefit risk analysis was then conducted. RESULTS: Twenty guidelines and/or protocols were selected; the majority of which came from Europe and Latin America. Seventeen interventions were identified and classified into 6 pharmacological groups. Antimalarials, lopinavir/ritonavir and remdesivir were the only agents recommended and supported by clinical trials. The remaining interventions were recommended based on indirect evidence, observational studies, or in vitro studies. CONCLUSIONS: Antimalarials have shown results against COVID-19 with surrogate outcomes and the presence of serious adverse events. We recommend active monitoring of agents with potential efficacy against SARS-CoV-2 and incorporating the results in national guidelines and protocols. Clinical trials should be conducted to show direct benefit with clinically relevant outcomes in various populations.
ANTECEDENTES: La nueva información de terapias contra el SARS-CoV-2 crece rápidamente. Como resultado, los países y organizaciones han comenzado a publicar pautas terapéuticas. OBJETIVO: Proporcionar una sinopsis de las recomendaciones soportadas en guías basadas en evidencia de las opciones terapéuticas con actividad potencial contra el SARS-CoV-2. MÉTODO: Revisión sistemática rápida de guías o protocolos que dan orientación clínica provisional para la enfermedad COVID-19 de PubMed/Medline, Web Of Science, Scopus, Scielo, Google Scholar y una búsqueda general en Google. Los duplicados se eliminaron y se incluyó un resumen de las intervenciones propuestas. Luego se realizó un análisis de riesgos y beneficios. RESULTADOS: Veinte guías o protocolos se seleccionaron, la mayor parte provino de Europa y Latinoamérica. Diecisiete intervenciones se identificaron y clasificaron en seis grupos farmacológicos. Los antimaláricos, lopinavir/ritonavir y remdesivir fueron los únicos agentes recomendados y respaldados por ensayos clínicos. Las intervenciones restantes se recomendaron con base en evidencia indirecta, estudios observacionales o estudios in vitro. CONCLUSIONES: Los antimaláricos han mostrado resultados contra COVID-19 con desenlaces sustitutos y eventos adversos graves. Recomendamos la vigilancia activa de agentes con eficacia potencial contra el SARS-CoV-2 incorporando los resultados en las guías y protocolos nacionales. Deben realizarse ensayos clínicos que muestren un beneficio directo con desenlaces clínicamente relevantes en diversas poblaciones.