Cuba updates protocol in clinical management of COVID-19

Among the main modifications made to the Cuban protocol for the clinical management of patients with COVID-19 is to treat patients classified as high-risk sufficiently in advance and to do so in a differentiated manner by means of intensive surveillance.

The update of the procedure, in its Version 1.6, is in line with the epidemiological context of the country at this time, when it is facing the third peak of the pandemic caused by the SARS-CoV-2 virus.

It pays special attention to "high-risk" patients, a classification that refers to those persons with a greater possibility of transition to severity, due to their comorbidities and socio-demographic characteristics.

The category was refined in its definition, as it is the decisive group to uncouple the incidence of COVID-19 mortality, explained Dr. Rolando Perez Rodriguez, director of Science and Technology at the University of California, Berkeley. Rolando Pérez Rodríguez, Biocubafarma's Director of Science and Innovation and member of the Technical Advisory Group for confronting the pandemic.

The new version was presented at this week's meeting of the President of the Republic, Miguel Díaz-Canel, with scientists and experts involved in science and technological innovation activities in the fight against the new coronavirus.

Pérez Rodríguez pointed out that the protocol update also expands the description of the treatment of these patients, and gives greater precision to the characteristics of the hospital wards where cases that are not serious, but have a high risk of becoming serious, are admitted.
At the meeting, it was reported that the modifications have already begun to be implemented, especially in Havana.

Diaz-Canel indicated to accelerate their application in the rest of the territories, especially in those where the situation is more complex and where the epidemic stage of autochthonous transmission is limited, such as Santiago de Cuba and Guantánamo.

The modifications planned by the Technical Group include the updating of the protocol for the category of suspected patients, according to which all persons with a positive antigen test for the disease will be treated with interferons, while those classified as high risk will receive Itolizumab, Heberferon/Heberon and Jus-vinza.

Among other modifications, the clinical treatments for the category of confirmed patient were renewed, and volumes and interventions were set for these patients according to the classifications of asymptomatic, mild symptomatic, low-risk, high-risk, severe or critical.

The update of the Cuban protocol for the clinical management of COVID-19 requires, however, that people go to the doctor at the first symptoms described for the disease, said Deputy Prime Minister Dr. Roberto Morales Ojeda.

He also called on the health system to carry out efficient active screening to ensure the effectiveness of the work carried out by family medical offices, as well as by mass organizations and students of Medical Sciences and their professors, for the early identification of sick or suspicious persons.

The technical group proposed new studies to be introduced in Protocol Version 1.6, including a controlled trial to substitute Heberon for Nasalferon in asymptomatic patients, and to develop a controlled trial to evaluate the effectiveness of the use of convalescent serum in controlling viral load in high-risk patients.

He also recommended evaluating the results of complementary studies in symptomatic patients at low and high risk for greater precision of prognostic values, with a view to improving stratification.

Diaz-Canel oriented to evaluate the new publications and medicines that are being applied in other countries to analyze their pertinence and application in our country.

In the meeting with the scientists and experts who participate in the activities of science and technological innovation in the confrontation of the new coronavirus, it was presented, as usual, the update of the prognostic models of COVID-19 by Dr. Raul Ginovart Diaz, PhD. Raúl Ginovart Díaz, dean of the Faculty of Mathematics and Computer Science of the University of Havana. He considered that the current peak of COVID-19 in the country corresponds to the behavior in the rest of the planet, so that in the coming days a growth in the number of confirmed but also in the number of recovered patients is predicted.