These updated recommendations form part of the managing COVID-19 guideline, which was first published in March. This guideline is a ‘living guideline’ which can be continuously updated to incorporate the latest evidence and keep abreast of new developments.
We have published an update to the conditional recommendation for using remdesivir in COVID-19 patients in hospital settings. We now advise that remdesivir should be considered for hospitalised patients, aged 12 years and over or weighing 40 kilograms or more, who are on low-flow supplemental oxygen (delivered through a face mask or nasal canula). Previously we advised that remdesivir should be considered for patients on supplemental oxygen but not on invasive mechanical ventilation. The update reflects a slightly different approach to our data analysis based on evidence that the use of remdesivir is more beneficial earlier in the course of disease. The length of treatment with remdesivir remains unchanged at 5 days.
While NICE does not recommend colchicine for treating COVID-19 patients in hospital, we recommend that further research should be carried out in community settings to see whether it might yet be an effective treatment.
At this stage, the expert committee concluded that there was insufficient evidence to recommend colchicine as a treatment for COVID-19 patients. This is the first time NICE has published advice on the use of colchicine to treat COVID-19.
Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “This updated guidance will help ensure healthcare staff treating COVID-19 patients have access to the latest evidence on what is and what isn’t effective as part of the ongoing efforts to understand how best to treat this disease.
“NICE is continuing to monitor and assess new evidence on potential and established COVID-19 therapeutics and will update the ‘living’ managing COVID-19 guideline when appropriate. This approach reflects both our flexible and rapid response to the COVID-19 pandemic, and our move towards a more dynamic approach to producing guideline recommendations as outlined in our 5-year strategy.
“NICE will continue to update users when new advice on COVID-19 is published, but we also encourage users to check the NICE website to make sure they do not miss any updates.”
The managing COVID-19 guideline was developed and published in the MAGICapp platform, a global system that promotes evidence sharing from different guideline creators, therefore increasing the speed at which guidance can be developed and the ease with which it can be updated.
The updated therapeutic recommendations can be read here.