IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i18p6845-d415978.html
   My bibliography  Save this article

Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain

Author

Listed:
  • Luis M. Pérez-Belmonte

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain
    Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain)

  • María D. López-Carmona

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain)

  • Juan L. Quevedo-Marín

    (Departamento de Bioquímica, Universidad Rey Juan Carlos, 28933 Madrid, Spain)

  • Michele Ricci

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain)

  • Jesica Martín-Carmona

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain)

  • Jaime Sanz-Cánovas

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain)

  • Almudena López-Sampalo

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain)

  • María D. Martín-Escalante

    (Servicio de Medicina Interna, Hospital Costa del Sol, 29603 Marbella, Spain)

  • M. Rosa. Bernal-López

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain
    Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain)

  • Ricardo Gómez-Huelgas

    (Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), 29010 Málaga, Spain
    Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain)

Abstract

Our objective was to compare clinical protocols for the treatment of the novel coronavirus disease 2019 (COVID-19) among different hospitals in Andalusia, Spain. We reviewed the current COVID-19 protocols of the 15 largest hospitals in Andalusia. Antiviral treatment, empirical antibacterial agents, adjunctive therapies, anticoagulant treatment, supportive care, hospital organization, and discharge recommendations were analyzed. All protocols included were the latest updates as of July 2020. Hydroxychloroquine in monotherapy was the most frequent antiviral drug recommended for mild respiratory illness with clinical risk factors (33.3%). Combined hydroxychloroquine with azithromycin or lopinavir/ritonavir was found in 40% of protocols. The recommended treatment for patients with mild and moderate pneumonias was different antiviral combinations including hydroxychloroquine plus azithromycin (93.3%) or hydroxychloroquine plus lopinavir/ritonavir (79.9%). Different combinations of hydroxychloroquine and lopinavir/ritonavir (46.7%) and triple therapy with hydroxychloroquine, azithromycin, and lopinavir/ritonavir (40%) were the most recommended treatments for patients with severe pneumonia. There were five corticosteroid regimens, which used dexamethasone, methylprednisolone, or prednisone, with different doses and treatment durations. Anakinra was included in seven protocols with six different regimens. All protocols included prophylactic heparin and therapeutic doses for thromboembolism. Higher prophylactic doses of heparin for high-risk patients and therapeutic doses for patients in critical condition were included in 53.3% and 33.3% of protocols, respectively. This study showed that COVID-19 protocols varied widely in several aspects (antiviral treatment, corticosteroids, anakinra, and anticoagulation for high risk of thrombosis or critical situation). Rigorous randomized clinical trials on the proposed treatments are needed to provide consistent evidence.

Suggested Citation

  • Luis M. Pérez-Belmonte & María D. López-Carmona & Juan L. Quevedo-Marín & Michele Ricci & Jesica Martín-Carmona & Jaime Sanz-Cánovas & Almudena López-Sampalo & María D. Martín-Escalante & M. Rosa. Ber, 2020. "Differences between Clinical Protocols for the Treatment of Coronavirus Disease 2019 (COVID-19) in Andalusia, Spain," IJERPH, MDPI, vol. 17(18), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6845-:d:415978
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/18/6845/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/18/6845/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Francesco Di Gennaro & Damiano Pizzol & Claudia Marotta & Mario Antunes & Vincenzo Racalbuto & Nicola Veronese & Lee Smith, 2020. "Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review," IJERPH, MDPI, vol. 17(8), pages 1-11, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jianlin Ren & Shasha Duan & Leihong Guo & Hongwan Li & Xiangfei Kong, 2022. "Effects of Return Air Inlets’ Location on the Control of Fine Particle Transportation in a Simulated Hospital Ward," IJERPH, MDPI, vol. 19(18), pages 1-21, September.
    2. M. A. Hannan & M. S. Abd Rahman & Ali Q. Al-Shetwi & R. A. Begum & Pin Jern Ker & M. Mansor & M. S. Mia & M. J. Hossain & Z. Y. Dong & T. M. I. Mahlia, 2022. "Impact Assessment of COVID-19 Severity on Environment, Economy and Society towards Affecting Sustainable Development Goals," Sustainability, MDPI, vol. 14(23), pages 1-23, November.
    3. Faruq Abdulla & Zulkar Nain & Md. Karimuzzaman & Md. Moyazzem Hossain & Azizur Rahman, 2021. "A Non-Linear Biostatistical Graphical Modeling of Preventive Actions and Healthcare Factors in Controlling COVID-19 Pandemic," IJERPH, MDPI, vol. 18(9), pages 1-14, April.
    4. José Manuel Hernández-Padilla & José Granero-Molina & María Dolores Ruiz-Fernández & Iria Dobarrio-Sanz & María Mar López-Rodríguez & Isabel María Fernández-Medina & Matías Correa-Casado & Cayetano Fe, 2020. "Design and Psychometric Analysis of the COVID-19 Prevention, Recognition and Home-Management Self-Efficacy Scale," IJERPH, MDPI, vol. 17(13), pages 1-14, June.
    5. Christian M. Hafner, 2020. "The Spread of the Covid-19 Pandemic in Time and Space," IJERPH, MDPI, vol. 17(11), pages 1-13, May.
    6. Javier Cachón-Zagalaz & M.ª Luisa Zagalaz-Sánchez & Víctor Arufe-Giráldez & Alberto Sanmiguel-Rodríguez & Gabriel González-Valero, 2021. "Physical Activity and Daily Routine among Children Aged 0–12 during the COVID-19 Pandemic in Spain," IJERPH, MDPI, vol. 18(2), pages 1-13, January.
    7. Alina Butu & Ioan Sebastian Brumă & Lucian Tanasă & Steliana Rodino & Codrin Dinu Vasiliu & Sebastian Doboș & Marian Butu, 2020. "The Impact of COVID-19 Crisis upon the Consumer Buying Behavior of Fresh Vegetables Directly from Local Producers. Case Study: The Quarantined Area of Suceava County, Romania," IJERPH, MDPI, vol. 17(15), pages 1-25, July.
    8. Manuel Mosqueira-Ourens & José M. Sánchez-Sáez & Aitor Pérez-Morcillo & Laura Ramos-Petersen & Andrés López-Del-Amo & José L. Tuimil & Adrián Varela-Sanz, 2021. "Effects of a 48-Day Home Quarantine during the Covid-19 Pandemic on the First Outdoor Running Session among Recreational Runners in Spain," IJERPH, MDPI, vol. 18(5), pages 1-11, March.
    9. Maria de Lourdes Aguiar-Oliveira & Aline Campos & Aline R. Matos & Caroline Rigotto & Adriana Sotero-Martins & Paulo F. P. Teixeira & Marilda M. Siqueira, 2020. "Wastewater-Based Epidemiology (WBE) and Viral Detection in Polluted Surface Water: A Valuable Tool for COVID-19 Surveillance—A Brief Review," IJERPH, MDPI, vol. 17(24), pages 1-19, December.
    10. Aureliusz Kosendiak & Magdalena Król & Milena Ściskalska & Marta Kepinska, 2021. "The Changes in Stress Coping, Alcohol Use, Cigarette Smoking and Physical Activity during COVID-19 Related Lockdown in Medical Students in Poland," IJERPH, MDPI, vol. 19(1), pages 1-15, December.
    11. An Cheng & Tonghui Chen & Guogang Jiang & Xinru Han, 2021. "Can Major Public Health Emergencies Affect Changes in International Oil Prices?," IJERPH, MDPI, vol. 18(24), pages 1-13, December.
    12. Ioana-Ancuta Iancu & Cosmin Pompei Darab & Stefan Dragos Cirstea, 2021. "The Effect of the COVID-19 Pandemic on the Electricity Consumption in Romania," ULB Institutional Repository 2013/351853, ULB -- Universite Libre de Bruxelles.
    13. Ali Alsaegh & Elena Belova & Yuriy Vasil’ev & Nadezhda Zabroda & Lyudmila Severova & Margarita Timofeeva & Denis Dobrokhotov & Alevtina Leonova & Oleg Mitrokhin, 2021. "COVID-19 in Dental Settings: Novel Risk Assessment Approach," IJERPH, MDPI, vol. 18(11), pages 1-10, June.
    14. Joanna Dymecka & Rafał Gerymski & Adrianna Iszczuk & Mariola Bidzan, 2021. "Fear of Coronavirus, Stress and Fear of Childbirth in Polish Pregnant Women during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(24), pages 1-10, December.
    15. Nada N. Alshehri & Maha A. AlQahtani & Fatima Riaz & Syed E. Mahmood & Ausaf Ahmad & Nawal F. AbdelGhaffar & Abdulaziz H. Abdullah Almakfor & Fawziah M. Alahmari & Hanan Abdulmutal & Mojahed Hadi A. R, 2023. "Neurological Manifestations and Clinical Outcomes of Patients with COVID-19 in the Aseer Region, Saudi Arabia," IJERPH, MDPI, vol. 20(5), pages 1-15, February.
    16. Shubhadeep Roychoudhury & Anandan Das & Pallav Sengupta & Sulagna Dutta & Shatabhisha Roychoudhury & Arun Paul Choudhury & A. B. Fuzayel Ahmed & Saumendra Bhattacharjee & Petr Slama, 2020. "Viral Pandemics of the Last Four Decades: Pathophysiology, Health Impacts and Perspectives," IJERPH, MDPI, vol. 17(24), pages 1-39, December.
    17. Luigi Bellocchio & Ioana Roxana Bordea & Andrea Ballini & Felice Lorusso & Denisa Hazballa & Ciro Gargiulo Isacco & Giuseppina Malcangi & Alessio Danilo Inchingolo & Gianna Dipalma & Francesco Inching, 2020. "Environmental Issues and Neurological Manifestations Associated with COVID-19 Pandemic: New Aspects of the Disease?," IJERPH, MDPI, vol. 17(21), pages 1-11, November.
    18. Alicja Lisiecka & Dorota Chimicz & Agnieszka Lewicka-Zelent, 2023. "Mental Health Support in Higher Education during the COVID-19 Pandemic: A Case Study and Recommendations for Practice," IJERPH, MDPI, vol. 20(6), pages 1-16, March.
    19. Krzysztof Rząsa & Mateusz Ciski, 2022. "Influence of the Demographic, Social, and Environmental Factors on the COVID-19 Pandemic—Analysis of the Local Variations Using Geographically Weighted Regression," IJERPH, MDPI, vol. 19(19), pages 1-26, September.
    20. Junjian Gu, 2020. "Risk Assessment on Continued Public Health Threats: Evidence from China’s Stock Market," IJERPH, MDPI, vol. 17(20), pages 1-30, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6845-:d:415978. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.