Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19

Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, da Sociedade Brasileira de Angiologia e Cirurgia Vascular, da Sociedade Brasileira de Infectologia, da Sociedade Brasileira de Pneumologia e Tisiologia e da Sociedade Brasileira de Reumatologia


  • Maicon Falavigna
  • Cinara Stein
  • José Luis Gomes do Amaral
  • Luciano Cesar Pontes de Azevedo
  • Karlyse Claudino Belli
  • Verônica Colpani
  • Clovis Arns da Cunha
  • Felipe Dal-Pizzol
  • Maria Beatriz Souza Dias
  • Juliana Carvalho Ferreira
  • Ana Paula da Rocha Freitas
  • Débora Dalmas Gräf
  • Hélio Penna Guimarães
  • Suzana Margareth Ajeje Lobo
  • José Tadeu Monteiro
  • Michelle Silva Nunes
  • Maura Salaroli de Oliveira
  • Clementina Corah Lucas Prado
  • Vania Cristina Canuto Santos
  • Rosemeri Maurici da Silva
  • Marcone Lima Sobreira
  • Viviane Cordeiro Veiga
  • Ávila Teixeira Vidal
  • Ricardo Machado Xavier
  • Alexandre Prehn Zavascki
  • Flávia Ribeiro Machado
  • Carlos Roberto Ribeiro de Carvalho




COVID-19, COVID-19/drug therapy, Health planning guidelines, SARS-CoV-2, Brazil


Introduction: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil.

Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method.

Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made.

Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.


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Como Citar

Falavigna, M. ., Stein, C. ., Luis Gomes do Amaral, J. ., Cesar Pontes de Azevedo, L. ., Claudino Belli, K. ., Colpani, V. ., Arns da Cunha, . C. ., Dal-Pizzol, F. ., Beatriz Souza Dias, M. ., Carvalho Ferreira, J. ., da Rocha Freitas, A. P. ., Dalmas Gräf, D., Penna Guimarães, H. ., Margareth Ajeje Lobo, S., Tadeu Monteiro, J. ., Silva Nunes, M. ., Salaroli de Oliveira, M. ., Corah Lucas Prado, C. ., Cristina Canuto Santos, V. ., Maurici da Silva, R. ., Lima Sobreira, M. ., Cordeiro Veiga, V. ., Teixeira Vidal, Ávila ., Machado Xavier, R. ., Prehn Zavascki, A., Ribeiro Machado, F. ., & Ribeiro de Carvalho, C. R. . (2022). Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19: Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, da Sociedade Brasileira de Angiologia e Cirurgia Vascular, da Sociedade Brasileira de Infectologia, da Sociedade Brasileira de Pneumologia e Tisiologia e da Sociedade Brasileira de Reumatologia. JBMEDE - Jornal Brasileiro De Medicina De Emergência, 2(1), e22006. https://doi.org/10.54143/jbmede.v2i1.69



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