Covid-19 Moderada/Grave
Tratamento de Pacientes Hospitalizados
Alexandre Naime Barbosa MD, PhD
Professor Doutor - Infectologia
Atualizando-se em HIV, Covid-19 e MPX
27/Ago/2022 - Virtual

Vínculos e Conflitos de Interesse (CFM e ANVISA)
Vínculos:
- UNESP/Medicina: Professor Doutor MD PhD, Vice-Chefe do Departamento de Infectologia
- HC FMB Botucatu: Infectologista Público e Privado, Coordenador do Grupo Técnico de Covid-19
- Sociedade Brasileira de Infectologia (SBI): Vice-Presidente e Membro Titular
- SBI: Coordenador do Comitê Covid-19, Membro dos Comitês de HIV/Aids e Título de Especialista
- Associação Médica Brasileira - Comitê Monitoramento COVID-19, e Diretrizes COVID-19
- Ministério da Saúde - Assessoria Técnica em Covid-19
Privados: Atheneu, Astrazeneca, Abbvie, Amgen-Bergamo, Boehringer Ingelheim, Celltrion, Dr. Reedy´s,
Eurofarma, GEN Educação, Gilead, GSK-ViiV, Guanabara Koogan, Janssen, Manole Educação,
Medictalks, MSD, Pfizer, Procter & Gamble, Sanofi Pasteur, S. C. Johnson & Son, Takeda, Uber, Unimed e
Wyeth.
Potenciais Conflitos de Interesse (Incentivos Diretos/Indiretos 12 Meses)
Públicos: CNPq, DECIT, FAPESP, Bill & Melinda Gates Fundation e Ministério da Saúde do Brasil

Covid-19: Linha de Cuidados Farmacológicos em 2022
Slide do autor

Covid-19: Intervenções na Covid Hospitalizada - 2022
Slide do autor
Tratamento Específico
1. Antivirais
2. Anticorpos Monoclonais
3. Imunomoduladores
4. Corticoides
5. Guidelines
Terapia de Suporte
1. Suplementação de O2
2. Anticoagulação
3. Avaliação Terapia Antimicrobiana

Covid Hospitalar: Uso de Antivirais

Rendesevir: Estudo NIAID (ACTT-1)

Rendesevir: Estudo NIAID (ACTT-1)

Rendesevir: Estudo NIAID (ACTT-1)

Rendesevir: Estudo NIAID (ACTT-1)

Rendesevir: Estudo NIAID (GS-US-540–5773)

Rendesevir: Estudo NIAID (WHO Solidarity)

Rendesevir: Estudo NIAID (WHO Solidarity)

Molnuperavir ou Nimatrelvir/r: Covid-19 Hospitalizada
The study included patients admitted to hospital during the SARSCoV-2
omicron BA.2 wave in Hong Kong between Feb 26, 2022, and April 26, 2022,
and who did not require supplemental oxygen at the time of admission, who
were given molnupiravir or nirmatrelvir–ritonavir.
For both antivirals, treatment was started within 2 days of admission to the
hospital. In patients with a known date of symptom onset (almost half of the
patients), the median time from symptom onset to drug administration was
1 day (IQR 1–3) for both drugs.
Lancet Infect Dis on-line. August 24, 2022

Molnuperavir ou Nimatrelvir/r: Covid-19 Hospitalizada
Lancet Infect Dis on-line. August 24, 2022

Molnuperavir ou Nimatrelvir/r: Covid-19 Hospitalizada
Lancet Infect Dis on-line. August 24, 2022

Molnuperavir ou Nimatrelvir/r: Covid-19 Hospitalizada
Lancet Infect Dis on-line. August 24, 2022

Molnuperavir ou Nimatrelvir/r: Covid-19 Hospitalizada
Early administration of oral antivirals in patients with mild-to moderate
COVID-19 was associated with a significantly lower risk of all-cause mortality (hazard
ratio 0·48 [95% CI 0·40–0·59], p<0·0001 for molnupiravir vs matched controls; 0·34
[0·23–0·50], p<0·0001 for nirmatrelvir–ritonavir vs matched controls).
The study was not a head-to-head comparison between the two antivirals
because of the imbalance in baseline characteristics between the groups.
Lancet Infect Dis on-line. August 24, 2022

Outros Antivirais: Covid-19 Hospitalizada

Outros Antivirais: Covid-19 Hospitalizada

Anticorpos Monoclonais: Covid-19 Hospitalizada
(Tixagevimabe e Cilgavimabe)

Adaptado de:
RECOVERY Collaborative Group.et al. N Engl J Med. 2021 Feb 25;384(8):693-704.
Covid-19: Corticoide na Covid Grave

Covid-19: Corticoide na Covid Grave

Covid-19: Rendesevir + Corticoide na Covid Grave

Baricitinib na Covid Grave

Baricitinib + Rendesevir na Covid Grave

Tocilizumab na Covid Grave

Tocilizumab na Covid Grave

NIH Covid-19 Guideline
https://www.covid19treatmentguidelines.nih.gov/

NIH Covid-19 Guideline
https://www.covid19treatmentguidelines.nih.gov/

NIH Covid-19 Guideline
https://www.covid19treatmentguidelines.nih.gov/

NIH Covid-19 Guideline
https://www.covid19treatmentguidelines.nih.gov/

Obrigado pela Atenção!
@dr.alexandre.naime.barbosa @drbarbosa
Dr. Alexandre Naime Barbosa
@NaimeDr