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January 25, 2023

Interim Clinical Considerations for COVID-19 Treatment in … – CDC

This page provides a treatment overview for healthcare providers.
For General Public: COVID-19 Treatments and Medications
Clinicians can use the links below to identify patients at risk for severe COVID-19 and who may benefit from outpatient treatment. Severe outcomes of COVID-19 are defined as hospitalization, intensive care, ventilatory support, or death. There may be other medical conditions associated with severe COVID-19 not listed here, and clinical judgment is needed.
Age is the most important risk factor for severe outcomes of COVID-19.
Risk factors for severe COVID-19 include:
Some people from racial and ethnic minority groups are at risk of being disproportionately affected by COVID-19 from many factors, including limited access to vaccines and healthcare.(1-3) Healthcare providers can consider these factors when evaluating the risk for severe COVID-19 and use of outpatient therapeutics.
More details: Actions Healthcare Providers Can Take for Patients at Higher Risk of Severe COVID-19
In a clinical trial, Paxlovid reduced the risk of hospitalization and death by 89% in unvaccinated outpatients with COVID-19 at higher risk of severe disease.(4) Serious adverse events are uncommon with Paxlovid treatment.(4) Paxlovid is given twice daily for 5 days, starting as soon as possible and within 5 days of symptom onset, and is approved for use in adult and pediatric patients (12 years of age and older weighing at least 40kg). Clinicians should be aware of the eligibility criteria and the potential for drug interactions with the use of Paxlovid that may preclude Paxlovid use or may require temporary discontinuation of other medications.
COVID-19 rebound has been reported to occur in a small percentage of patients between 2 and 8 days after initial recovery and is characterized by recurrent but milder symptoms and viral detection after having tested negative. For more information about viral rebound and the recurrence of COVID-19 symptoms, refer to the NIH COVID-19 Treatment Guidelines: Ritonavir-Boosted Nirmatrelvir (Paxlovid).
Remdesivir (Veklury) reduced the risk of hospitalization and death by 87% in unvaccinated outpatients with COVID-19 at higher risk of severe disease.(5) A 3-day course of intravenous remdesivir initiated within 7 days of symptom onset is the second preferred treatment option after Paxlovid for adults and pediatric patients (age >28 days and weight > 3kg).
When Paxlovid or remdesivir are not accessible or clinically appropriate, the oral antiviral molnupiravir can be used.(6-7) Clinicians can use the link below to review details on eligibility and indication.
The U.S. Food and Drug Administration (FDA) has also issued an Emergency Use Authorization (EUA) to permit the emergency use of COVID-19 convalescent plasma with high titers of anti-SARS-CoV-2 antibodies for the treatment of COVID-19 in patients with immunosuppressive disease or receiving immunosuppressive treatment, in either the outpatient or inpatient setting. For more information, please see the FDA Fact Sheet for Providers. The NIH COVID-19 Treatment Guidelines, also provide recommendations on who should be considered for this treatment.
All patients with symptomatic COVID-19 should be offered symptom management with over-the-counter antipyretics, analgesics, or antitussives for fever, headache, myalgias, and cough.(7)
For Healthcare Providers
For Patients
Names of specific vendors, manufacturers, or products in this collection of content are included for public health and informational purposes; inclusion does not imply endorsement of the vendors, manufacturers, or products by the Centers for Disease Control and Prevention or the US Department of Health and Human Services.
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