gms | German Medical Science

Hintergrund: 85% of patients with COVID-19 in Germany are dealt with in the Primary Care setting. It stands to reason that the ability of Primary Care to provide treatments for the amelioration of COVID-19 symptoms, thus avoiding patient admissions to Secondary Care wherever possible, warrants the development of a therapeutic strategy to guide Primary Care Physicians.

Fragestellung: To provide the best current evidence for and against the use of symptomatic treatments for acute Covid-19 patients in Primary Care.

Methoden: CEOSys is a national evidence network of 21 universities and 4 non-university partners within Germany, working collaboratively to create a ‘living evidence ecosystem’ of results from current COVID-19 primary research articles. Methodologists cooperate with clinical experts in identification, assessment and synthesis of these studies.

Ergebnisse: Raw Data from 132 international clinical studies have been extracted by CEOSys; 33 studies were deemed as relevant to the Primary Care settings, of which 15 full text articles were available. For the systematic review, studies with all types of comparators were included. For the Meta-analyses, only studies with one therapeutic comparator or comparison to placebo were included. The current results of effects of pharmacotherapies in the Primary Care setting will be presented including Ivermectin, DOACs, Corticosteroids and Vitamin D. Data for a further three relevant medications, monoclonal antibodies, Colchicine, and Aspirin, are awaited.

Diskussion: Developing guidelines for the treatment of acute COVID-19 patients in the Primary Care setting is important in order to prevent deterioration of patients, and is crucial to avert individual suffering and the efficient use of finite health care resources. So far there is an obvious research gap in the literature for clinical studies in pre-hospitalised patients.

Take Home Message für die Praxis: A living evidence ecosystem supports the pandemic preparedness strategy and can provide practical recommendations for Primary Care physicians.