infections
COVID 19
Treatment of COVID 19
Medications to relieve fever and muscle aches Sometimes, for people with mild to moderate illness with high-risk of severe disease: nirmatrelvir/ritonavircombination;remdesivir(short course);molnupiravir For severe illness:remdesivir;dexamethasone; immunomodulators Treatment of COVID-19 depends on how severe the illness is and the likelihood that the person will develop severe disease. For mild illness, resting at home is often sufficient.Acetaminophenor a nonsteroidal anti-inflammatory drug (NSAID), such asibuprofen, may be taken to relieve fever and muscle aches. Despite initial anecdotal concerns, there is no scientific evidence that the use of NSAIDs worsens COVID-19. Similarly, there is no scientific evidence that people with COVID-19 who take the blood pressure medications called angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) should stop taking them. For more severe illness, some people require hospitalization with treatment that might include supplemental oxygen or Mechanical Ventilation . For people with severe illness from COVID-19 or people at high risk for progression to severe disease, some medication and other therapies are recommended. For example, some immunomodulator therapies (such astocilizumab,baricitinib, orsarilumab) may be used for severe disease. This is a rapidly evolving topic (seeNational Institutes of Health (NIH) COVID-19 Treatment GuidelinesandInfectious Diseases Society of America (IDSA) Guidelines on the Treatment and Management of Patients with COVID-19). The combination medicationnirmatrelvir andritonaviris an antiviral medication taken by mouth. It may be used to treat mild to moderate COVID-19 infection in some adults and adolescents who are at high risk for progression to severe COVID-19, including hospitalization or death. It is not authorized for use for longer than 5 consecutive days. Some people have symptoms return after usingnirmatrelvir/ritonavir, and tests for SARS-CoV-2 can become positive again, even in people who do not have symptoms return. Additional treatment is not currently recommended, but people should isolate if rebound symptoms or tests occur. (See alsoCDC: COVID-19 Rebound After Paxlovid Treatment.) Remdesivir(an antiviral drug) is for the treatment for select people with COVID-19.Remdesiviris given intravenously. The recommended treatment duration is 3 to 10 days. The combination ofremdesivirand the corticosteroiddexamethasoneis commonly used in hospitalized people who need supplemental oxygen. Molnupiraviris an antiviral medication taken by mouth. It may be used to treat mild to moderate COVID-19 infection in nonhospitalized adults who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options are not available or appropriate.Molnupiraviris not authorized for use for longer than 5 consecutive days. It is not recommended for use during pregnancy. Bamlanivimab/etesevimab,casirivimab/imdevimab,sotrovimab, andbebtelovimabare monoclonal antibody therapies. They are not effective against the Omicron variant. Therefore, the FDA recommended against their use in treatment of COVID-19, because Omicron has become the dominant variant in the United States. The following therapies are also NOT recommended for the treatment or prevention of COVID-19: Vilobelimab, a monoclonal antibody (not yet recommended in clinical guidelines) Blood plasma from recovered patients Nonspecific immunoglobulin (IVIG) and mesenchymal stem cell therapy Additional immunomodulatory therapies, including interferons, kinase inhibitors, and interleukin inhibitors Azithromycinand antiretrovirals Lopinavir/ritonavir(an HIV retroviral) Chloroquineandhydroxychloroquine(antimalaria medications) Ivermectin(an antiparasite medication): the FDA and other organizations have issued warnings about toxicity from the inappropriate use ofivermectinpreparations intended for large animal use (seeFDA: Why You Should Not Use Ivermectin to Treat or Prevent COVID-19). 