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ACOEM and MDGuidelines® Release First Evidence-Based COVID-19 Guideline for Occupational Health

04/13/2020
The American College of Occupational and Environmental Medicine (ACOEM) and MDGuidelines today released a new clinical practice guideline focusing on novel coronavirus 2019 (COVID-19). Because of the need to provide clinicians with the most up-to-date information possible, the COVID-19 guideline is available free of charge at https://info.mdguidelines.com/covid-19. The ACOEM Practice Guidelines in MDGuidelines are widely used by clinicians in the care and treatment of working-age individuals.
 
COVID-19, the acute respiratory infection caused by a new strain of coronavirus (SARSCoV-2), has disrupted the normal course of business worldwide. The COVID-19 guideline provides recommendations for employer considerations, a discussion of disability considerations, and diagnostic approach, as well as treatment recommendations.
 
“The urgency of the COVID-19 pandemic necessitates the quick development and delivery of guidelines for use by health care systems, physicians, governmental agencies, and organizations managing worker safety and health,” said Kurt T. Hegmann, MD, editor-in-chief of the ACOEM Practice Guidelines. “Using the best-quality evidence available, we are able to offer guidance today for workplace safety, observations on possible impact on disability, and treatment recommendations for patients who are moderately to severely affected by COVID-19.”
 
Workplace Safety
Among the evidence-based guidance for workplace safety, the COVID-19 guideline outlines the following for employers:
  • Ensure the ability for affected workers to sufficiently observe a quarantine period which may include examining paid leave policies.
  • If affected workers are in fact sick, examine provisions to allow employees to stay at home.
  • If workers are not sick but need to care for the sick, examine provisions to allow for these circumstances.
  • Stop all non-essential travel to any cities/countries with outbreaks or community spread in family members.
Treatment Recommendations
Based on review of the preliminary data available, and determinations by the U.S. Food and Drug Administration, the COVID-19 guideline includes the following treatment recommendations:
 
Recommended:
  • Hydroxychloroquine or chloroquine as possible treatments for patients who are moderately to severely affected by COVID-19; azithromycin may be added for severely affected patients
  • Convalescent plasma antibodies from survivors of COVID-19 as possible treatment for patients who are severely affected by COVID-19
  • Interleukin-6 (IL-6) receptor anatagonists (tocilizumab and sarilumab) as possible treatments for patients who are severely affected by COVID-19
Not recommended:
  • Hydroxychloroquine and chloroquine are not recommended for widespread prophylactic use
  • Lopinavir/ritonavir are not recommended
No recommendation:
  • Favipiravir
Recognizing the urgent need for workplace recommendations related to COVID-19, ACOEM however cautions that quality literature is quite limited for treatment of COVID-19, [therefore] aspects of this guideline could rapidly become out of date. “We intend to monitor the literature frequently and update the COVID-19 guideline as needed,” noted Stephen Frangos, MD, ACOEM President.
 
All ACOEM Practice Guidelines are developed using a state-of-the-art methodology which incorporates the highest scientific standards for reviewing evidence-based literature to ensure the most rigorous, reproducible, and transparent guidelines available. All recommendations are labeled as: strongly recommended, moderately recommended, recommended, consensus-recommended, consensus-no recommendation, consensus—not recommended, not recommended, moderately not recommended, or strongly not recommended based on the strength of the scientific evidence. The strength of evidence ratings included with the recommendations are used to designate the quality and amount of evidence that supports the recommendation. All guidelines are reviewed periodically to identify any major changes in the evidence.
 
Development of the COVID-19 guideline was overseen by Kurt Hegmann, MD, and the Evidence-Based Practice COVID-19 Panel. Physician panelists represent expertise in occupational medicine, internal medicine, pulmonary medicine, and infectious disease.

For more information about or to access the COVID-19 guideline, visit https://info.mdguidelines.com/covid-19, or contact Joe Guerriero at jguerriero@mdguidelines.com.
 
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About ACOEM and Its Practice Guidelines
The American College of Occupational and Environmental Medicine (www.acoem.org) is an international society of 4,000 occupational physicians and other health care professionals. The College provides leadership to promote optimal health and safety of workers, workplaces, and environments. The College is located in Elk Grove Village, Ill.
 
ACOEM’s Occupational Medicine Practice Guidelines define best practices for key areas of occupational medical care and disability management. They are intended to improve the efficiency and accuracy of the diagnostic process as well as identify the effectiveness and risks of individual treatments in resolving an illness or injury—helping workers return to normal activities as quickly and safely as possible.
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About MDGuidelines
MDGuidelines, is the industry’s leading solution for total health management and workplace productivity. MDGuidelines features the world’s most trusted disability durations, predictive modeling, analytic services, drug formulary, and evidence-based clinical practice guidelines from ACOEM.