![]() H These individuals should receive oximetry monitoring and close follow-up through telehealth, visiting nurse services, or in-person visits. Therefore, it should be used only when the preferred options are not available, feasible to use, or clinically appropriate. G Molnupiravir has lower efficacy than the preferred treatment options. Therefore, bebtelovimab should be used only when the preferred treatment options are not available, feasible to use, or clinically appropriate. See Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications for more information.ĭ If a patient requires hospitalization after starting treatment, the full treatment course can be completed at the health care provider’s discretion.Į Administration of remdesivir requires 3 consecutive days of IV infusion.į Bebtelovimab is active in vitro against all circulating Omicron subvariants, but there are no clinical efficacy data from placebo-controlled trials that evaluated the use of bebtelovimab in patients who are at high risk of progressing to severe COVID-19. Clinicians should carefully review a patient’s concomitant medications and evaluate potential drug-drug interactions. ![]() Using systemic glucocorticoids in this setting may cause harm.ī For a list of risk factors, see the CDC webpage Underlying Medical Conditions Associated With Higher Risk for Severe COVID-19.Ĭ Ritonavir-boosted nirmatrelvir has significant drug-drug interactions. Rating of Evidence: I = One or more randomized trials without major limitations IIa = Other randomized trials or subgroup analyses of randomized trials IIb = Nonrandomized trials or observational cohort studies III = Expert opinionĪ There is currently a lack of safety and efficacy data on the use of dexamethasone in outpatients with COVID-19. Rating of Recommendations: A = Strong B = Moderate C = Weak As remdesivir requires IV infusions for up to 5 consecutive days, there may be logistical constraints to administering remdesivir in the outpatient setting. The Panel recommends using dexamethasone 6 mg PO once daily for the duration of supplemental oxygen (dexamethasone use should not exceed 10 days) with careful monitoring for AEs ( BIII).īecause remdesivir is recommended for patients with similar oxygen needs who are hospitalized, j clinicians may consider using it in this setting. When hospital resources are limited, inpatient admission is not possible, and close follow-up is ensuredi There is insufficient evidence to recommend either for or against the continued use of remdesivir or dexamethasone.ĭischarged From ED Despite New or Increasing Need for Supplemental Oxygen The Panel recommends against continuing the use of remdesivir ( AIIa), dexamethasone a ( AIIa), or baricitinib ( AIIa) after hospital discharge.ĭischarged From Hospital Inpatient Setting and Requires Supplemental Oxygenįor those who are stable enough for discharge but still require oxygenh Listed in alphabetical order:ĭischarged From Hospital Inpatient Setting in Stable Condition and Does Not Require Supplemental Oxygen For use ONLY when neither of the preferred therapies are available, feasible to use, or clinically appropriate. Ritonavir-boosted nirmatrelvir (Paxlovid) c,d ( AIIa)Īlternative therapies.The Panel recommends against the use of dexamethasone a or other systemic corticosteroids in the absence of another indication ( AIIb).įor Patients Who Are at High Risk of Progressing to Severe COVID-19 b.All patients should be offered symptomatic management ( AIII).Therapeutic Management of Nonhospitalized Adults with COVID-19ĭoes Not Require Hospitalization or Supplemental Oxygen
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