A living WHO guideline on drugs to prevent covid-19.
Identifieur interne : 000290 ( Main/Corpus ); précédent : 000289; suivant : 000291A living WHO guideline on drugs to prevent covid-19.
Auteurs : François Lamontagne ; Thomas Agoritsas ; Reed Siemieniuk ; Bram Rochwerg ; Jessica Bartoszko ; Lisa Askie ; Helen Macdonald ; Wagdy Amin ; Frederique Jacquerioz Bausch ; Erlina Burhan ; Maurizio Cecconi ; Duncan Chanda ; Vu Quoc Dat ; Bin Du ; Heike Geduld ; Patrick Gee ; Harley Nerina ; Madiha Hashimi ; Beverley J. Hunt ; Sushil Kabra ; Seema Kanda ; Leticia Kawano-Dourado ; Yae-Jean Kim ; Niranjan Kissoon ; Arthur Kwizera ; Yee-Sin Leo ; Imelda Mahaka ; Hela Manai ; Greta Mino ; Emmanuel Nsutebu ; Natalia Pshenichnaya ; Nida Qadir ; Shalini Sri Ranganathan ; Saniya Sabzwari ; Rohit Sarin ; Michael Sharland ; Yinzhong Shen ; Joao Paulo Souza ; Miriam Stegemann ; Sebastian Ugarte ; Sridhar Venkatapuram ; Dubula Vuyiseka ; Jacobus Preller ; Romina Brignardello-Petersen ; Elena Kum ; Anila Qasim ; Dena Zeraatkar ; Andrew Owen ; Gordon Guyatt ; Lyubov Lytvyn ; Janet Diaz ; Per Olav Vandvik ; Michael JacobsSource :
- BMJ (Clinical research ed.) [ 1756-1833 ] ; 2021.
English descriptors
- KwdEn :
- COVID-19 (epidemiology), COVID-19 (prevention & control), Chemoprevention (methods), Chemoprevention (standards), Clinical Decision-Making (methods), Humans (MeSH), Hydroxychloroquine (pharmacology), Immunologic Factors (pharmacology), Risk Assessment (MeSH), SARS-CoV-2 (drug effects), Uncertainty (MeSH), World Health Organization (MeSH).
- MESH :
- chemical , pharmacology : Hydroxychloroquine, Immunologic Factors.
- drug effects : SARS-CoV-2.
- epidemiology : COVID-19.
- methods : Chemoprevention, Clinical Decision-Making.
- prevention & control : COVID-19.
- standards : Chemoprevention.
- Humans, Risk Assessment, Uncertainty, World Health Organization.
Abstract
CLINICAL QUESTION
What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19.
RECOMMENDATION
The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty).
HOW THIS GUIDELINE WAS CREATED
This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
UNDERSTANDING THE NEW RECOMMENDATION
The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19.
UPDATES
This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline.
READERS NOTE
This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.
DOI: 10.1136/bmj.n526
PubMed: 33649077
Links to Exploration step
pubmed:33649077Le document en format XML
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Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Siemieniuk, Reed" sort="Siemieniuk, Reed" uniqKey="Siemieniuk R" first="Reed" last="Siemieniuk">Reed Siemieniuk</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Rochwerg, Bram" sort="Rochwerg, Bram" uniqKey="Rochwerg B" first="Bram" last="Rochwerg">Bram Rochwerg</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Bartoszko, Jessica" sort="Bartoszko, Jessica" uniqKey="Bartoszko J" first="Jessica" last="Bartoszko">Jessica Bartoszko</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Askie, Lisa" sort="Askie, Lisa" uniqKey="Askie L" first="Lisa" last="Askie">Lisa Askie</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Macdonald, Helen" sort="Macdonald, Helen" uniqKey="Macdonald H" first="Helen" last="Macdonald">Helen Macdonald</name><affiliation><nlm:affiliation>The BMJ, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Amin, Wagdy" sort="Amin, Wagdy" uniqKey="Amin W" first="Wagdy" last="Amin">Wagdy Amin</name><affiliation><nlm:affiliation>Ministry of Health and Population, Cairo, Egypt.</nlm:affiliation></affiliation></author><author><name sortKey="Bausch, Frederique Jacquerioz" sort="Bausch, Frederique Jacquerioz" uniqKey="Bausch F" first="Frederique Jacquerioz" last="Bausch">Frederique Jacquerioz Bausch</name><affiliation><nlm:affiliation>Geneva University Hospital, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Burhan, Erlina" sort="Burhan, Erlina" uniqKey="Burhan E" first="Erlina" last="Burhan">Erlina Burhan</name><affiliation><nlm:affiliation>Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia.</nlm:affiliation></affiliation></author><author><name sortKey="Cecconi, Maurizio" sort="Cecconi, Maurizio" uniqKey="Cecconi M" first="Maurizio" last="Cecconi">Maurizio Cecconi</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Chanda, Duncan" sort="Chanda, Duncan" uniqKey="Chanda D" first="Duncan" last="Chanda">Duncan Chanda</name><affiliation><nlm:affiliation>Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia.</nlm:affiliation></affiliation></author><author><name sortKey="Dat, Vu Quoc" sort="Dat, Vu Quoc" uniqKey="Dat V" first="Vu Quoc" last="Dat">Vu Quoc Dat</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name><affiliation><nlm:affiliation>Peking Union Medical College Hospital, Beijing, China.</nlm:affiliation></affiliation></author><author><name sortKey="Geduld, Heike" sort="Geduld, Heike" uniqKey="Geduld H" first="Heike" last="Geduld">Heike Geduld</name><affiliation><nlm:affiliation>Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Gee, Patrick" sort="Gee, Patrick" uniqKey="Gee P" first="Patrick" last="Gee">Patrick Gee</name><affiliation><nlm:affiliation>USA.</nlm:affiliation></affiliation></author><author><name sortKey="Nerina, Harley" sort="Nerina, Harley" uniqKey="Nerina H" first="Harley" last="Nerina">Harley Nerina</name><affiliation><nlm:affiliation>Royal Melbourne Hospital, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hashimi, Madiha" sort="Hashimi, Madiha" uniqKey="Hashimi M" first="Madiha" last="Hashimi">Madiha Hashimi</name><affiliation><nlm:affiliation>Ziauddin University, Karachi, Pakistan.</nlm:affiliation></affiliation></author><author><name sortKey="Hunt, Beverley J" sort="Hunt, Beverley J" uniqKey="Hunt B" first="Beverley J" last="Hunt">Beverley J. Hunt</name><affiliation><nlm:affiliation>Guy's & St Thomas' NHS Foundation Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Kabra, Sushil" sort="Kabra, Sushil" uniqKey="Kabra S" first="Sushil" last="Kabra">Sushil Kabra</name><affiliation><nlm:affiliation>All India Institute of Medical Sciences, New Delhi, India.</nlm:affiliation></affiliation></author><author><name sortKey="Kanda, Seema" sort="Kanda, Seema" uniqKey="Kanda S" first="Seema" last="Kanda">Seema Kanda</name><affiliation><nlm:affiliation>McMaster University (alumnus).</nlm:affiliation></affiliation></author><author><name sortKey="Kawano Dourado, Leticia" sort="Kawano Dourado, Leticia" uniqKey="Kawano Dourado L" first="Leticia" last="Kawano-Dourado">Leticia Kawano-Dourado</name><affiliation><nlm:affiliation>Pulmonary Division, Heart Institute (InCor)- HCFMUSP, Medical School, University of Sao Paulo, São Paulo, Brazil and Research Institute, Hospital do Coração (HCor), São Paulo, Brazil.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name><affiliation><nlm:affiliation>Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kissoon, Niranjan" sort="Kissoon, Niranjan" uniqKey="Kissoon N" first="Niranjan" last="Kissoon">Niranjan Kissoon</name><affiliation><nlm:affiliation>Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Kwizera, Arthur" sort="Kwizera, Arthur" uniqKey="Kwizera A" first="Arthur" last="Kwizera">Arthur Kwizera</name><affiliation><nlm:affiliation>Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Leo, Yee Sin" sort="Leo, Yee Sin" uniqKey="Leo Y" first="Yee-Sin" last="Leo">Yee-Sin Leo</name><affiliation><nlm:affiliation>National Center for Infectious Diseases, Singapore.</nlm:affiliation></affiliation></author><author><name sortKey="Mahaka, Imelda" sort="Mahaka, Imelda" uniqKey="Mahaka I" first="Imelda" last="Mahaka">Imelda Mahaka</name><affiliation><nlm:affiliation>Pangaea Harare, Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Manai, Hela" sort="Manai, Hela" uniqKey="Manai H" first="Hela" last="Manai">Hela Manai</name><affiliation><nlm:affiliation>Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia.</nlm:affiliation></affiliation></author><author><name sortKey="Mino, Greta" sort="Mino, Greta" uniqKey="Mino G" first="Greta" last="Mino">Greta Mino</name><affiliation><nlm:affiliation>Alcivar Hospital, Guayaquil, Ecuador.</nlm:affiliation></affiliation></author><author><name sortKey="Nsutebu, Emmanuel" sort="Nsutebu, Emmanuel" uniqKey="Nsutebu E" first="Emmanuel" last="Nsutebu">Emmanuel Nsutebu</name><affiliation><nlm:affiliation>Sheikh Shakhbout Medical City, Abu Dhabi, UAE.</nlm:affiliation></affiliation></author><author><name sortKey="Pshenichnaya, Natalia" sort="Pshenichnaya, Natalia" uniqKey="Pshenichnaya N" first="Natalia" last="Pshenichnaya">Natalia Pshenichnaya</name><affiliation><nlm:affiliation>Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russia.</nlm:affiliation></affiliation></author><author><name sortKey="Qadir, Nida" sort="Qadir, Nida" uniqKey="Qadir N" first="Nida" last="Qadir">Nida Qadir</name><affiliation><nlm:affiliation>Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Ranganathan, Shalini Sri" sort="Ranganathan, Shalini Sri" uniqKey="Ranganathan S" first="Shalini Sri" last="Ranganathan">Shalini Sri Ranganathan</name><affiliation><nlm:affiliation>University of Colombo, Colombo, Sri Lanka.</nlm:affiliation></affiliation></author><author><name sortKey="Sabzwari, Saniya" sort="Sabzwari, Saniya" uniqKey="Sabzwari S" first="Saniya" last="Sabzwari">Saniya Sabzwari</name><affiliation><nlm:affiliation>Aga Khan University, Karachi, Pakistan.</nlm:affiliation></affiliation></author><author><name sortKey="Sarin, Rohit" sort="Sarin, Rohit" uniqKey="Sarin R" first="Rohit" last="Sarin">Rohit Sarin</name><affiliation><nlm:affiliation>National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.</nlm:affiliation></affiliation></author><author><name sortKey="Sharland, Michael" sort="Sharland, Michael" uniqKey="Sharland M" first="Michael" last="Sharland">Michael Sharland</name><affiliation><nlm:affiliation>St. George's University Hospital, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Shen, Yinzhong" sort="Shen, Yinzhong" uniqKey="Shen Y" first="Yinzhong" last="Shen">Yinzhong Shen</name><affiliation><nlm:affiliation>Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Souza, Joao Paulo" sort="Souza, Joao Paulo" uniqKey="Souza J" first="Joao Paulo" last="Souza">Joao Paulo Souza</name><affiliation><nlm:affiliation>University of Sao Paulo, Sao Paulo, Brazil.</nlm:affiliation></affiliation></author><author><name sortKey="Stegemann, Miriam" sort="Stegemann, Miriam" uniqKey="Stegemann M" first="Miriam" last="Stegemann">Miriam Stegemann</name><affiliation><nlm:affiliation>Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ugarte, Sebastian" sort="Ugarte, Sebastian" uniqKey="Ugarte S" first="Sebastian" last="Ugarte">Sebastian Ugarte</name><affiliation><nlm:affiliation>Faculty of Medicine Andres Bello University, Indisa Clinic, Santiago, Chile.</nlm:affiliation></affiliation></author><author><name sortKey="Venkatapuram, Sridhar" sort="Venkatapuram, Sridhar" uniqKey="Venkatapuram S" first="Sridhar" last="Venkatapuram">Sridhar Venkatapuram</name><affiliation><nlm:affiliation>King's College, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Vuyiseka, Dubula" sort="Vuyiseka, Dubula" uniqKey="Vuyiseka D" first="Dubula" last="Vuyiseka">Dubula Vuyiseka</name><affiliation><nlm:affiliation>University of Stellenbosch, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Preller, Jacobus" sort="Preller, Jacobus" uniqKey="Preller J" first="Jacobus" last="Preller">Jacobus Preller</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Brignardello Petersen, Romina" sort="Brignardello Petersen, Romina" uniqKey="Brignardello Petersen R" first="Romina" last="Brignardello-Petersen">Romina Brignardello-Petersen</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Kum, Elena" sort="Kum, Elena" uniqKey="Kum E" first="Elena" last="Kum">Elena Kum</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Qasim, Anila" sort="Qasim, Anila" uniqKey="Qasim A" first="Anila" last="Qasim">Anila Qasim</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Zeraatkar, Dena" sort="Zeraatkar, Dena" uniqKey="Zeraatkar D" first="Dena" last="Zeraatkar">Dena Zeraatkar</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Owen, Andrew" sort="Owen, Andrew" uniqKey="Owen A" first="Andrew" last="Owen">Andrew Owen</name><affiliation><nlm:affiliation>University of Liverpool, Liverpool, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Guyatt, Gordon" sort="Guyatt, Gordon" uniqKey="Guyatt G" first="Gordon" last="Guyatt">Gordon Guyatt</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Lytvyn, Lyubov" sort="Lytvyn, Lyubov" uniqKey="Lytvyn L" first="Lyubov" last="Lytvyn">Lyubov Lytvyn</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Diaz, Janet" sort="Diaz, Janet" uniqKey="Diaz J" first="Janet" last="Diaz">Janet Diaz</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author><author><name sortKey="Vandvik, Per Olav" sort="Vandvik, Per Olav" uniqKey="Vandvik P" first="Per Olav" last="Vandvik">Per Olav Vandvik</name><affiliation><nlm:affiliation>MAGIC Evidence Ecosystem Foundation, Oslo, Norway.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author><author><name sortKey="Jacobs, Michael" sort="Jacobs, Michael" uniqKey="Jacobs M" first="Michael" last="Jacobs">Michael Jacobs</name><affiliation><nlm:affiliation>Royal Free London NHS Foundation Trust, London, UK francois.lamontagne@usherbrooke.ca michael.jacobs@ucl.ac.uk.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33649077</idno><idno type="pmid">33649077</idno><idno type="doi">10.1136/bmj.n526</idno><idno type="wicri:Area/Main/Corpus">000290</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000290</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A living WHO guideline on drugs to prevent covid-19.</title><author><name sortKey="Lamontagne, Francois" sort="Lamontagne, Francois" uniqKey="Lamontagne F" first="François" last="Lamontagne">François Lamontagne</name><affiliation><nlm:affiliation>Université de Sherbrooke, Centre de recherche due CHU de Sherbrooke, Sherbrooke, Quebec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Agoritsas, Thomas" sort="Agoritsas, Thomas" uniqKey="Agoritsas T" first="Thomas" last="Agoritsas">Thomas Agoritsas</name><affiliation><nlm:affiliation>Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>MAGIC Evidence Ecosystem Foundation, Oslo, Norway.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Siemieniuk, Reed" sort="Siemieniuk, Reed" uniqKey="Siemieniuk R" first="Reed" last="Siemieniuk">Reed Siemieniuk</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Rochwerg, Bram" sort="Rochwerg, Bram" uniqKey="Rochwerg B" first="Bram" last="Rochwerg">Bram Rochwerg</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Bartoszko, Jessica" sort="Bartoszko, Jessica" uniqKey="Bartoszko J" first="Jessica" last="Bartoszko">Jessica Bartoszko</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Askie, Lisa" sort="Askie, Lisa" uniqKey="Askie L" first="Lisa" last="Askie">Lisa Askie</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Macdonald, Helen" sort="Macdonald, Helen" uniqKey="Macdonald H" first="Helen" last="Macdonald">Helen Macdonald</name><affiliation><nlm:affiliation>The BMJ, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Amin, Wagdy" sort="Amin, Wagdy" uniqKey="Amin W" first="Wagdy" last="Amin">Wagdy Amin</name><affiliation><nlm:affiliation>Ministry of Health and Population, Cairo, Egypt.</nlm:affiliation></affiliation></author><author><name sortKey="Bausch, Frederique Jacquerioz" sort="Bausch, Frederique Jacquerioz" uniqKey="Bausch F" first="Frederique Jacquerioz" last="Bausch">Frederique Jacquerioz Bausch</name><affiliation><nlm:affiliation>Geneva University Hospital, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Burhan, Erlina" sort="Burhan, Erlina" uniqKey="Burhan E" first="Erlina" last="Burhan">Erlina Burhan</name><affiliation><nlm:affiliation>Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia.</nlm:affiliation></affiliation></author><author><name sortKey="Cecconi, Maurizio" sort="Cecconi, Maurizio" uniqKey="Cecconi M" first="Maurizio" last="Cecconi">Maurizio Cecconi</name><affiliation><nlm:affiliation>Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Chanda, Duncan" sort="Chanda, Duncan" uniqKey="Chanda D" first="Duncan" last="Chanda">Duncan Chanda</name><affiliation><nlm:affiliation>Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia.</nlm:affiliation></affiliation></author><author><name sortKey="Dat, Vu Quoc" sort="Dat, Vu Quoc" uniqKey="Dat V" first="Vu Quoc" last="Dat">Vu Quoc Dat</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam.</nlm:affiliation></affiliation></author><author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name><affiliation><nlm:affiliation>Peking Union Medical College Hospital, Beijing, China.</nlm:affiliation></affiliation></author><author><name sortKey="Geduld, Heike" sort="Geduld, Heike" uniqKey="Geduld H" first="Heike" last="Geduld">Heike Geduld</name><affiliation><nlm:affiliation>Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Gee, Patrick" sort="Gee, Patrick" uniqKey="Gee P" first="Patrick" last="Gee">Patrick Gee</name><affiliation><nlm:affiliation>USA.</nlm:affiliation></affiliation></author><author><name sortKey="Nerina, Harley" sort="Nerina, Harley" uniqKey="Nerina H" first="Harley" last="Nerina">Harley Nerina</name><affiliation><nlm:affiliation>Royal Melbourne Hospital, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hashimi, Madiha" sort="Hashimi, Madiha" uniqKey="Hashimi M" first="Madiha" last="Hashimi">Madiha Hashimi</name><affiliation><nlm:affiliation>Ziauddin University, Karachi, Pakistan.</nlm:affiliation></affiliation></author><author><name sortKey="Hunt, Beverley J" sort="Hunt, Beverley J" uniqKey="Hunt B" first="Beverley J" last="Hunt">Beverley J. Hunt</name><affiliation><nlm:affiliation>Guy's & St Thomas' NHS Foundation Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Kabra, Sushil" sort="Kabra, Sushil" uniqKey="Kabra S" first="Sushil" last="Kabra">Sushil Kabra</name><affiliation><nlm:affiliation>All India Institute of Medical Sciences, New Delhi, India.</nlm:affiliation></affiliation></author><author><name sortKey="Kanda, Seema" sort="Kanda, Seema" uniqKey="Kanda S" first="Seema" last="Kanda">Seema Kanda</name><affiliation><nlm:affiliation>McMaster University (alumnus).</nlm:affiliation></affiliation></author><author><name sortKey="Kawano Dourado, Leticia" sort="Kawano Dourado, Leticia" uniqKey="Kawano Dourado L" first="Leticia" last="Kawano-Dourado">Leticia Kawano-Dourado</name><affiliation><nlm:affiliation>Pulmonary Division, Heart Institute (InCor)- HCFMUSP, Medical School, University of Sao Paulo, São Paulo, Brazil and Research Institute, Hospital do Coração (HCor), São Paulo, Brazil.</nlm:affiliation></affiliation></author><author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name><affiliation><nlm:affiliation>Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Kissoon, Niranjan" sort="Kissoon, Niranjan" uniqKey="Kissoon N" first="Niranjan" last="Kissoon">Niranjan Kissoon</name><affiliation><nlm:affiliation>Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Kwizera, Arthur" sort="Kwizera, Arthur" uniqKey="Kwizera A" first="Arthur" last="Kwizera">Arthur Kwizera</name><affiliation><nlm:affiliation>Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Leo, Yee Sin" sort="Leo, Yee Sin" uniqKey="Leo Y" first="Yee-Sin" last="Leo">Yee-Sin Leo</name><affiliation><nlm:affiliation>National Center for Infectious Diseases, Singapore.</nlm:affiliation></affiliation></author><author><name sortKey="Mahaka, Imelda" sort="Mahaka, Imelda" uniqKey="Mahaka I" first="Imelda" last="Mahaka">Imelda Mahaka</name><affiliation><nlm:affiliation>Pangaea Harare, Zimbabwe.</nlm:affiliation></affiliation></author><author><name sortKey="Manai, Hela" sort="Manai, Hela" uniqKey="Manai H" first="Hela" last="Manai">Hela Manai</name><affiliation><nlm:affiliation>Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia.</nlm:affiliation></affiliation></author><author><name sortKey="Mino, Greta" sort="Mino, Greta" uniqKey="Mino G" first="Greta" last="Mino">Greta Mino</name><affiliation><nlm:affiliation>Alcivar Hospital, Guayaquil, Ecuador.</nlm:affiliation></affiliation></author><author><name sortKey="Nsutebu, Emmanuel" sort="Nsutebu, Emmanuel" uniqKey="Nsutebu E" first="Emmanuel" last="Nsutebu">Emmanuel Nsutebu</name><affiliation><nlm:affiliation>Sheikh Shakhbout Medical City, Abu Dhabi, UAE.</nlm:affiliation></affiliation></author><author><name sortKey="Pshenichnaya, Natalia" sort="Pshenichnaya, Natalia" uniqKey="Pshenichnaya N" first="Natalia" last="Pshenichnaya">Natalia Pshenichnaya</name><affiliation><nlm:affiliation>Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russia.</nlm:affiliation></affiliation></author><author><name sortKey="Qadir, Nida" sort="Qadir, Nida" uniqKey="Qadir N" first="Nida" last="Qadir">Nida Qadir</name><affiliation><nlm:affiliation>Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Ranganathan, Shalini Sri" sort="Ranganathan, Shalini Sri" uniqKey="Ranganathan S" first="Shalini Sri" last="Ranganathan">Shalini Sri Ranganathan</name><affiliation><nlm:affiliation>University of Colombo, Colombo, Sri Lanka.</nlm:affiliation></affiliation></author><author><name sortKey="Sabzwari, Saniya" sort="Sabzwari, Saniya" uniqKey="Sabzwari S" first="Saniya" last="Sabzwari">Saniya Sabzwari</name><affiliation><nlm:affiliation>Aga Khan University, Karachi, Pakistan.</nlm:affiliation></affiliation></author><author><name sortKey="Sarin, Rohit" sort="Sarin, Rohit" uniqKey="Sarin R" first="Rohit" last="Sarin">Rohit Sarin</name><affiliation><nlm:affiliation>National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.</nlm:affiliation></affiliation></author><author><name sortKey="Sharland, Michael" sort="Sharland, Michael" uniqKey="Sharland M" first="Michael" last="Sharland">Michael Sharland</name><affiliation><nlm:affiliation>St. George's University Hospital, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Shen, Yinzhong" sort="Shen, Yinzhong" uniqKey="Shen Y" first="Yinzhong" last="Shen">Yinzhong Shen</name><affiliation><nlm:affiliation>Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Souza, Joao Paulo" sort="Souza, Joao Paulo" uniqKey="Souza J" first="Joao Paulo" last="Souza">Joao Paulo Souza</name><affiliation><nlm:affiliation>University of Sao Paulo, Sao Paulo, Brazil.</nlm:affiliation></affiliation></author><author><name sortKey="Stegemann, Miriam" sort="Stegemann, Miriam" uniqKey="Stegemann M" first="Miriam" last="Stegemann">Miriam Stegemann</name><affiliation><nlm:affiliation>Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ugarte, Sebastian" sort="Ugarte, Sebastian" uniqKey="Ugarte S" first="Sebastian" last="Ugarte">Sebastian Ugarte</name><affiliation><nlm:affiliation>Faculty of Medicine Andres Bello University, Indisa Clinic, Santiago, Chile.</nlm:affiliation></affiliation></author><author><name sortKey="Venkatapuram, Sridhar" sort="Venkatapuram, Sridhar" uniqKey="Venkatapuram S" first="Sridhar" last="Venkatapuram">Sridhar Venkatapuram</name><affiliation><nlm:affiliation>King's College, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Vuyiseka, Dubula" sort="Vuyiseka, Dubula" uniqKey="Vuyiseka D" first="Dubula" last="Vuyiseka">Dubula Vuyiseka</name><affiliation><nlm:affiliation>University of Stellenbosch, South Africa.</nlm:affiliation></affiliation></author><author><name sortKey="Preller, Jacobus" sort="Preller, Jacobus" uniqKey="Preller J" first="Jacobus" last="Preller">Jacobus Preller</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Brignardello Petersen, Romina" sort="Brignardello Petersen, Romina" uniqKey="Brignardello Petersen R" first="Romina" last="Brignardello-Petersen">Romina Brignardello-Petersen</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Kum, Elena" sort="Kum, Elena" uniqKey="Kum E" first="Elena" last="Kum">Elena Kum</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Qasim, Anila" sort="Qasim, Anila" uniqKey="Qasim A" first="Anila" last="Qasim">Anila Qasim</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Zeraatkar, Dena" sort="Zeraatkar, Dena" uniqKey="Zeraatkar D" first="Dena" last="Zeraatkar">Dena Zeraatkar</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Owen, Andrew" sort="Owen, Andrew" uniqKey="Owen A" first="Andrew" last="Owen">Andrew Owen</name><affiliation><nlm:affiliation>University of Liverpool, Liverpool, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Guyatt, Gordon" sort="Guyatt, Gordon" uniqKey="Guyatt G" first="Gordon" last="Guyatt">Gordon Guyatt</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Lytvyn, Lyubov" sort="Lytvyn, Lyubov" uniqKey="Lytvyn L" first="Lyubov" last="Lytvyn">Lyubov Lytvyn</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation></author><author><name sortKey="Diaz, Janet" sort="Diaz, Janet" uniqKey="Diaz J" first="Janet" last="Diaz">Janet Diaz</name><affiliation><nlm:affiliation>World Health Organization, Geneva, Switzerland.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author><author><name sortKey="Vandvik, Per Olav" sort="Vandvik, Per Olav" uniqKey="Vandvik P" first="Per Olav" last="Vandvik">Per Olav Vandvik</name><affiliation><nlm:affiliation>MAGIC Evidence Ecosystem Foundation, Oslo, Norway.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author><author><name sortKey="Jacobs, Michael" sort="Jacobs, Michael" uniqKey="Jacobs M" first="Michael" last="Jacobs">Michael Jacobs</name><affiliation><nlm:affiliation>Royal Free London NHS Foundation Trust, London, UK francois.lamontagne@usherbrooke.ca michael.jacobs@ucl.ac.uk.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>. co-senior author.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMJ (Clinical research ed.)</title><idno type="eISSN">1756-1833</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (epidemiology)</term><term>COVID-19 (prevention & control)</term><term>Chemoprevention (methods)</term><term>Chemoprevention (standards)</term><term>Clinical Decision-Making (methods)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (pharmacology)</term><term>Immunologic Factors (pharmacology)</term><term>Risk Assessment (MeSH)</term><term>SARS-CoV-2 (drug effects)</term><term>Uncertainty (MeSH)</term><term>World Health Organization (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Hydroxychloroquine</term><term>Immunologic Factors</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Chemoprevention</term><term>Clinical Decision-Making</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Chemoprevention</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Risk Assessment</term><term>Uncertainty</term><term>World Health Organization</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>CLINICAL QUESTION</b></p><p>What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19.</p></div><div type="abstract" xml:lang="en"><p><b>RECOMMENDATION</b></p><p>The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty).</p></div><div type="abstract" xml:lang="en"><p><b>HOW THIS GUIDELINE WAS CREATED</b></p><p>This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p></div><div type="abstract" xml:lang="en"><p><b>UNDERSTANDING THE NEW RECOMMENDATION</b></p><p>The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19.</p></div><div type="abstract" xml:lang="en"><p><b>UPDATES</b></p><p>This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline.</p></div><div type="abstract" xml:lang="en"><p><b>READERS NOTE</b></p><p>This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33649077</PMID><DateCompleted><Year>2021</Year><Month>03</Month><Day>08</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>18</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1756-1833</ISSN><JournalIssue CitedMedium="Internet"><Volume>372</Volume><PubDate><Year>2021</Year><Month>03</Month><Day>01</Day></PubDate></JournalIssue><Title>BMJ (Clinical research ed.)</Title><ISOAbbreviation>BMJ</ISOAbbreviation></Journal><ArticleTitle>A living WHO guideline on drugs to prevent covid-19.</ArticleTitle><Pagination><MedlinePgn>n526</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmj.n526</ELocationID><Abstract><AbstractText Label="CLINICAL QUESTION">What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19.</AbstractText><AbstractText Label="RECOMMENDATION">The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty).</AbstractText><AbstractText Label="HOW THIS GUIDELINE WAS CREATED">This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</AbstractText><AbstractText Label="UNDERSTANDING THE NEW RECOMMENDATION">The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19.</AbstractText><AbstractText Label="UPDATES">This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline.</AbstractText><AbstractText Label="READERS NOTE">This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.</AbstractText><CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lamontagne</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Université de Sherbrooke, Centre de recherche due CHU de Sherbrooke, Sherbrooke, Quebec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agoritsas</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>MAGIC Evidence Ecosystem Foundation, Oslo, Norway.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Siemieniuk</LastName><ForeName>Reed</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rochwerg</LastName><ForeName>Bram</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bartoszko</LastName><ForeName>Jessica</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Askie</LastName><ForeName>Lisa</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>World Health Organization, Geneva, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Macdonald</LastName><ForeName>Helen</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>The BMJ, London, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Amin</LastName><ForeName>Wagdy</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Ministry of Health and Population, Cairo, Egypt.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bausch</LastName><ForeName>Frederique Jacquerioz</ForeName><Initials>FJ</Initials><AffiliationInfo><Affiliation>Geneva University Hospital, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Burhan</LastName><ForeName>Erlina</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cecconi</LastName><ForeName>Maurizio</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chanda</LastName><ForeName>Duncan</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dat</LastName><ForeName>Vu Quoc</ForeName><Initials>VQ</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Du</LastName><ForeName>Bin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Peking Union Medical College Hospital, Beijing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Geduld</LastName><ForeName>Heike</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gee</LastName><ForeName>Patrick</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nerina</LastName><ForeName>Harley</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Royal Melbourne Hospital, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hashimi</LastName><ForeName>Madiha</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Ziauddin University, Karachi, Pakistan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hunt</LastName><ForeName>Beverley J</ForeName><Initials>BJ</Initials><AffiliationInfo><Affiliation>Guy's & St Thomas' NHS Foundation Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kabra</LastName><ForeName>Sushil</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>All India Institute of Medical Sciences, New Delhi, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kanda</LastName><ForeName>Seema</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>McMaster University (alumnus).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kawano-Dourado</LastName><ForeName>Leticia</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Pulmonary Division, Heart Institute (InCor)- HCFMUSP, Medical School, University of Sao Paulo, São Paulo, Brazil and Research Institute, Hospital do Coração (HCor), São Paulo, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Yae-Jean</ForeName><Initials>YJ</Initials><AffiliationInfo><Affiliation>Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kissoon</LastName><ForeName>Niranjan</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kwizera</LastName><ForeName>Arthur</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leo</LastName><ForeName>Yee-Sin</ForeName><Initials>YS</Initials><AffiliationInfo><Affiliation>National Center for Infectious Diseases, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mahaka</LastName><ForeName>Imelda</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Pangaea Harare, Zimbabwe.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Manai</LastName><ForeName>Hela</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mino</LastName><ForeName>Greta</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Alcivar Hospital, Guayaquil, Ecuador.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nsutebu</LastName><ForeName>Emmanuel</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Sheikh Shakhbout Medical City, Abu Dhabi, UAE.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pshenichnaya</LastName><ForeName>Natalia</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qadir</LastName><ForeName>Nida</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ranganathan</LastName><ForeName>Shalini Sri</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>University of Colombo, Colombo, Sri Lanka.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sabzwari</LastName><ForeName>Saniya</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Aga Khan University, Karachi, Pakistan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sarin</LastName><ForeName>Rohit</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sharland</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>St. George's University Hospital, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shen</LastName><ForeName>Yinzhong</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Souza</LastName><ForeName>Joao Paulo</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>University of Sao Paulo, Sao Paulo, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stegemann</LastName><ForeName>Miriam</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ugarte</LastName><ForeName>Sebastian</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Faculty of Medicine Andres Bello University, Indisa Clinic, Santiago, Chile.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Venkatapuram</LastName><ForeName>Sridhar</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>King's College, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vuyiseka</LastName><ForeName>Dubula</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>University of Stellenbosch, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Preller</LastName><ForeName>Jacobus</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>World Health Organization, Geneva, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brignardello-Petersen</LastName><ForeName>Romina</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kum</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qasim</LastName><ForeName>Anila</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeraatkar</LastName><ForeName>Dena</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Owen</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University of Liverpool, Liverpool, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guyatt</LastName><ForeName>Gordon</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lytvyn</LastName><ForeName>Lyubov</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Diaz</LastName><ForeName>Janet</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>World Health Organization, Geneva, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. co-senior author.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vandvik</LastName><ForeName>Per Olav</ForeName><Initials>PO</Initials><AffiliationInfo><Affiliation>MAGIC Evidence Ecosystem Foundation, Oslo, Norway.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. Not guideline development panel member; resource for methodology, systematic review, and content support.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. co-senior author.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jacobs</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Royal Free London NHS Foundation Trust, London, UK francois.lamontagne@usherbrooke.ca michael.jacobs@ucl.ac.uk.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>. co-senior author.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>001</GrantID><Acronym>WHO_</Acronym><Agency>World Health Organization</Agency><Country>International</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017065">Practice Guideline</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>03</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ</MedlineTA><NlmUniqueID>8900488</NlmUniqueID><ISSNLinking>0959-8138</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007155">Immunologic Factors</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018890" MajorTopicYN="Y">Chemoprevention</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000066491" MajorTopicYN="N">Clinical Decision-Making</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007155" MajorTopicYN="N">Immunologic Factors</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018570" MajorTopicYN="Y">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D035501" MajorTopicYN="N">Uncertainty</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014944" MajorTopicYN="N">World Health Organization</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>Competing interests: All guideline panel members have completed the WHO interest disclosure form. All authors have completed the BMJ Rapid Recommendations interest of disclosure form. The WHO, MAGIC, and The BMJ judged that no panel member had any financial conflict of interest. Professional and academic interests are minimised as much as possible, while maintaining necessary expertise on the panel to make fully informed decisions. MAGIC and TheBMJ assessed declared interests from other co-authors of this publication and found no conflicts of interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>3</Month><Day>2</Day><Hour>6</Hour><Minute>9</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>3</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>3</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33649077</ArticleId><ArticleId IdType="doi">10.1136/bmj.n526</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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