INTRODUCTION The Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP) constituted an expert panel for developing evidence-based guidance for the clinical management of adult patients with coronavirus disease 2019 (COVID-19) outside intensive care units. METHODS Ten systematic literature searches were performed to answer ten different key questions. The retrieved evidence was graded according to the Grading of Recommendations Assessment, Development, and Evaluation methodology (GRADE). RESULTS AND CONCLUSION The literature searches mostly assessed the available evidence on the management of COVID-19 patients in terms of antiviral, anticoagulant, anti-inflammatory, immunomodulatory, and continuous positive airway pressure (CPAP)/non-invasive ventilation (NIV) treatment. Most evidence was deemed as of low certainty, and in some cases, recommendations could not be developed according to the GRADE system (best practice recommendations were provided in similar situations). The use of neutralizing monoclonal antibodies may be considered for outpatients at risk of disease progression. For inpatients, favorable recommendations were provided for anticoagulant prophylaxis and systemic steroids administration, although with low certainty of evidence. Favorable recommendations, with very low/low certainty of evidence, were also provided for, in specific situations, remdesivir, alone or in combination with baricitinib, and tocilizumab. The presence of many best practice recommendations testified to the need for further investigations by means of randomized controlled trials, whenever possible, with some possible future research directions stemming from the results of the ten systematic reviews.

中文翻译：

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重症监护病房外的成年 COVID-19 患者的临床管理：意大利抗感染治疗协会 (SITA) 和意大利肺病学会 (SIP) 的指南。

简介 意大利抗感染治疗学会 (SITA) 和意大利肺病学会 (SIP) 组成了一个专家小组，负责为重症监护外 2019 年冠状病毒病 (COVID-19) 成年患者的临床管理制定循证指南单位。方法进行了十项系统文献检索，以回答十个不同的关键问题。检索到的证据根据建议评估、制定和评估方法分级 (GRADE) 进行分级。结果与结论 文献检索主要评估了抗病毒、抗凝、抗炎、免疫调节和持续气道正压通气 (CPAP)/无创通气 (NIV) 治疗方面有关 COVID-19 患者管理的现有证据。大多数证据被认为质量较低，在某些情况下，无法根据 GRADE 系统制定建议（在类似情况下提供了最佳实践建议）。对于有疾病进展风险的门诊患者，可以考虑使用中和单克隆抗体。对于住院患者，尽管证据质量较低，但仍提供了抗凝预防和全身类固醇给药的有利建议。在特定情况下，还为单独使用瑞德西韦或与巴瑞克替尼和托珠单抗联合使用提供了有利的建议，但证据质量非常低/低。许多最佳实践建议的存在证明，只要有可能，就需要通过随机对照试验进行进一步研究，并从十项系统评价的结果中得出一些可能的未来研究方向。