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- TABLE 1
Treating COVID-19: 32 recommendations from the Infectious Diseases Society of America
Recommended Not recommended Dexamethasone for hospitalized critically ill patients
Dexamethasone for hospitalized patients with severe but noncritical COVID-19
Tocilizumab for hospitalized adults with progressive severe or critical COVID-19 who have elevated markers of systemic inflammation
Sarilumab for patients who would qualify for tocilizumab, if tocilizumab is not available
Convalescent plasma for ambulatory patients with mild to moderate COVID-19 at high risk of progressing to severe disease who have no other treatment options, within 8 days of symptom onset
Remdesivir for patients with mild to moderate COVID-19 within 7 days of symptom onset at high risk of progressing to severe disease
Remdesivir for 5 days rather than 10 days for patients on supplemental oxygen but not on mechanical ventilation or extracorporeal mechanical ventilation
Remdesivir for hospitalized patients with severe COVID-19
Baricitinib with corticosteroids for hospitalized adults with severe COVID-19
Baricitinib with remdesivir for hospitalized patients with severe COVID-19 who cannot receive a corticosteroid
Tofacitinib for hospitalized adults with severe COVID-19 but not on noninvasive or invasive mechanical ventilation
Fluvoxamine (but only in a clinical trial)
Nirmatrelvir-ritonavir within 5 days of symptom onset in ambulatory patients with mild to moderate COVID-19 at high risk of progressing to severe disease
Molnupiravir within 5 days of symptom onset in ambulatory adults with mild to moderate COVID-19 at high risk of progressingHydroxychloroquine
Hydroxychloroquine plus azithromycin for hospitalized patients with COVID-19
Hydroxychloroquine for patients exposed to COVID-19
Lopinavir-ritonavir for patients exposed to COVID-19
Lopinavir-ritonavir for ambulatory patients with mild to moderate COVID-19
Lopinavir-ritonavir for hospitalized patients
Glucocorticoids for hospitalized patients with mild to moderate COVID-19 without hypoxemia requiring supplemental oxygen
Inhaled corticosteroids for ambulatory patients with mild to moderate COVID-19
Convalescent plasma for hospitalized immunocompetent patients
Routine use of convalescent plasma for hospitalized immunocompromised patients
Remdesivir for those on mechanical ventilation, extracorporeal membrane oxygenation, or both
Famotidine for ambulatory patients with mild to moderate COVID-19
Famotidine for hospitalized patients with severe COVID-19
Ivermectin for hospitalized patients
Ivermectin for ambulatory patients
Colchicine for hospitalized patients
Colchicine for ambulatory patients
Anakinra for hospitalized patients with severe COVID-19Based on information in reference 1.
Age > 65, or age > 50 and not vaccinated Chronic lung disease (chronic obstructive pulmonary disease, asthma, interstitial lung disease, pulmonary hypertension, bronchiectasis) Cardiovascular disease (heart failure, coronary artery disease, or cardiomyopathy) Type 2 diabetes Obesity (body mass index > 30 kg/m2) Sickle cell disease Chronic kidney disease Primary immunodeficiency or immunocompromised state from solid-organ transplantation Cancer Based on information in reference 2.
Asymptomatic or mild with no high-risk features Mild with high-risk features (see Table 2) Moderate with high-risk features Features None Fever, cough, change in taste or smell, no difficulty breathing Symptoms and clinical or radiographic evidence of lower respiratory tract disease Oxygen saturation ≥ 94% Isolation Yes Yes Yes Treatment None Molnupiravir or remdesivir Molnupiravir or remdesivir Based on information in reference 1.
Mild or moderate Severe Critical Features Symptoms
Oxygen saturation ≥ 94%Oxygen saturation < 94%
Respiratory rate ≥ 30 breaths/min
Lung infiltrates on chest radiography > 50%Respiratory failure requiring high-flow nasal cannula or noninvasive mechanical ventilation Respiratory failure requiring invasive mechanical ventilation or extracorporeal membrane oxygenation Isolation Yes Yes Yes Yes Treatment Remdesivir Remdesivir plus dexamethasone Dexamethasone with or without remdesivir
Consider an immune modulatorDexamethasone plus baricitinib, tofacitinib, or tocilizumab Based on information in reference 1.
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