- The US National Institutes of Health (NIH) COVID-19 treatment guidelines recommend against use of any agents for prophylaxis outside of a clinical trial.
Why this matters
- Agency cautions that “no drug has been proven to be safe and effective for treating COVID-19.”
- Evidence is "insufficient" for/against any antiviral or immunomodulatory therapy for disease of any severity.
- Nasopharyngeal testing recommended, with priority given to:
- Hospitalized patients, symptomatic health care workers.
- Symptomatic persons, age >65 years or with comorbidities, residing in long-term care facilities; symptomatic first responders.
- Communities experiencing high COVID-19 hospitalizations: symptomatic, critical infrastructure workers, health care workers, first responders, persons with mild symptoms.
- Treatment: none recommended outside clinical trial.
- Pre/asymptomatic: self-isolate for 7 days after first test (if tested); no further testing/treatment recommended.
- Mild: manage in ambulatory or telemedicine settings.
- Data are insufficient for/against antiviral, immunomodulatory treatment.
- Moderate: admit to hospital for close observation; administer empiric antibiotic if bacterial pneumonia or sepsis is strongly suspected.
- Conduct initial imaging, labs.
- Severe: SpO2 93% at sea level, respiratory rate >30, PaO2/FiO2 50%.
- Use aerosol-generating procedures, conduct imaging/labs.
- Critical: see guidelines.
- Special considerations (pregnancy, postdelivery, pediatric cases): see guidelines.
- Concomitant medications: see guidelines.