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COVID-19 Treatment Guidelines Show Great Global Variance

Findings based on review of national versus WHO guidelines

By Lori Solomon HealthDay Reporter

THURSDAY, April 25, 2024 (HealthDay News) — There is significant global variation in COVID-19 treatment recommendations and disease severity stratifications, according to a study published online April 22 in BMJ Global Health.

Mia Cokljat, M.B.Ch.B., from the University of Oxford in the United Kingdom, and colleagues compared the COVID-19 treatment guidelines of each World Health Organization (WHO) member state to the WHO COVID-19 therapeutic guidelines. The analysis included COVID-19 therapeutic national guidelines for 109 of the 194 WHO member states.

The researchers found considerable variation in guidelines and in disease severity stratifications. There were also substantial differences in therapeutic recommendations in many national guidelines versus the WHO guidelines. In late 2022, 93 percent of national guidelines were recommending at least one treatment that had been proven to be ineffective in large, randomized trials and was not recommended by WHO. For example, corticosteroids were not recommended in severe disease in nearly 10 percent of national guidelines, despite overwhelming evidence of their benefit. For countries categorized as low-resource settings, national guidelines showed the greatest divergence.

“The formalization of processes in the development of national guidelines for COVID-19 and other infectious diseases is essential for ensuring that these guidelines are grounded in the best available evidence,” the authors write. “A systematic and structured approach would not only enhance the credibility of the guidelines but could also contribute to their effectiveness in guiding public health interventions, especially in a pandemic setting.”

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