ORCHESTRA Delphi Consensus: Diagnostic and Therapeutic Management of SARS-CoV-2 Infection in Rheumatological Patients.
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Caponcello MG, Navarro PO, Bonazzetti C, Campoli C, Savoldi A, Gentilotti E, Monforte Ad, Lo Caputo S, Otero-Varela L, Castrejón I, Tacconelli E, Rodríguez-Baño J, Palacios-Baena ZR, Rheumatological Expert team , Mendoza DM, Navarrete VM, Tomelleri A, Ljung L, Rocha TM, Palma P, Salamanca-Rivera E, Paniagua-García M, Fassio A, Bixio R, Tombetti E, Garufi C, Conti F, ORCHESTRA WP4 working group
Clin Microbiol Infect - (-) -
[2025-03-04; online 2025-03-04]
The clinical management of COVID-19 in immunocompromised patients remains a challenge. The aim of this work was to develop a consensus to establish recommendations for the clinical, diagnostic and therapeutic management of patients with rheumatic diseases and COVID-19. A panel of 14 international experts was selected and Delphi methodology was used for the consensus, after a systematic literature review. Twenty-four questions were formulated and presented to the panel. The experts voted using a 6-point Likert scale 1) "Strongly disagree" (SD); 2) "Disagree" (D); 3) "Somewhat disagree" (SWD); 4) "Somewhat agree" (SWA); 5) "Agree" (A); 6) "Strongly agree" (SA). To establish consensus, simple or cumulative agreement ≥80% was required over a maximum of 3 rounds. Cumulative agreement was defined as the sum of response percentages on items 1-2 (SD + D); 2-3 (D+SWD); 4-5 (SWA+A); or 5-6 (A+SA), distinguishing a strong degree of agreement (A+SA) or disagreement (SD+D) from a moderate degree of agreement (SWA+A) or disagreement (D+SWD). After the 3 rounds, consensus was reached on 23 of the 24 questions and 10 recommendations were made. The Delphi methodology allowed consensus on recommendations in areas with insufficient scientific evidence, which can be considered for decision-making in the management of rheumatological patients while awaiting better evidence.
PubMed 40049395
DOI 10.1016/j.cmi.2025.02.030
Crossref 10.1016/j.cmi.2025.02.030
pii: S1198-743X(25)00091-6