Maisonneuve, Emeline; de Bruin, Odette; Favre, Guillaume; Goncé, Anna; Donati, Serena; Engjom, Hilde; Hurley, Eimir; Al-Fadel, Nouf; Siiskonen, Satu; Bloemenkamp, Kitty; Nordeng, Hedvig; Sturkenboom, Miriam; Baud, David; Panchaud, Alice (2023). Evolution of National Guidelines on Medicines Used to Treat COVID-19 in Pregnancy in 2020-2022: A Scoping Review. Journal of clinical medicine, 12(13), p. 4519. MDPI 10.3390/jcm12134519
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The lack of inclusion of pregnant women in clinical trials evaluating the effectiveness of medicines to treat COVID-19 has made it difficult to establish evidence-based treatment guidelines for pregnant women. Our aim was to provide a review of the evolution and updates of the national guidelines on medicines used in pregnant women with COVID-19 published by the obstetrician and gynecologists' societies in thirteen countries in 2020-2022. Based on the results of the RECOVERY (Randomized Evaluation of COVID-19 Therapy) trial, the national societies successively recommended against prescribing hydroxychloroquine, lopinavir-ritonavir and azithromycin. Guidelines for remdesivir differed completely between countries, from compassionate or conditional use to recommendation against. Nirmatrelvir-ritonavir was authorized in Australia and the UK only in research settings and was no longer recommended in the UK at the end of 2022. After initial reluctance to use corticosteroids, the results of the RECOVERY trial have enabled the recommendation of dexamethasone in case of severe COVID-19 since mid-2020. Some societies recommended prescribing tocilizumab to pregnant patients with hypoxia and systemic inflammation from June 2021. Anti-SARS-CoV-2 monoclonal antibodies were authorized at the end of 2021 with conditional use in some countries, and then no longer recommended in Belgium and the USA at the end of 2022. The gradual convergence of the recommendations, although delayed compared to the general population, highlights the importance of the inclusion of pregnant women in clinical trials and of international collaboration to improve the pharmacological treatment of pregnant women with COVID-19.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) |
Graduate School: |
Graduate School for Health Sciences (GHS) |
UniBE Contributor: |
Maisonneuve, Emeline Louise Jacqueline, Panchaud Monnat, Alice Elke Martine |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
2077-0383 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
17 Jul 2023 12:12 |
Last Modified: |
18 Jul 2023 18:09 |
Publisher DOI: |
10.3390/jcm12134519 |
PubMed ID: |
37445553 |
Uncontrolled Keywords: |
COVID-19 clinical practice guidelines national guidelines pregnancy |
BORIS DOI: |
10.48350/184845 |
URI: |
https://boris.unibe.ch/id/eprint/184845 |
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