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Coronavirus Disease 2019 (COVID-19)

Guidelines

Guidelines Summary

Numerous clinical guidelines have been issued for COVID-19. The following guidelines have been summarized at Medscape's COVID-19 Clinical Guidelines center:

COVID-19 Enforcement Policy for Sterilizers, Disinfectant Devices, and Air Purifiers (FDA, 2020): 2020 COVID-19 guidance for industry and FDA staff
OSHA Guidance on Preparing the Workplace for COVID-19 (2020): 2020 guidance on preparing the workplace for coronavirus disease 2019 (COVID-19) by the Occupational Safety and Health Administration (OSHA)
COVID-19 Breast Cancer Patient Triage Guidelines (CPBCC): Guidelines on surgical triage of patients with breast cancer by the COVID 19 Pandemic Breast Cancer Consortium
Procedures in Known/Suspected COVID-19 (ASA, 2020): 2020 guidelines on performing procedures on patients with known or suspected COVID-19 by the American Society of Anesthesiologists (ASA)
COVID-19–Related Airway Management Clinical Practice Guidelines (SIAARTI/EAMS, 2020): 2020 clinical practice guidelines from the SIAARTI Airway Research Group and the European Airway Management Society on coronavirus disease 2019 (COVID-19)–related airway management.
Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19): Panel consisting of 36 experts from 12 countries compiled 54 evidence-based statements for clinicians caring for patients with severe COVID-19 infection. (Updated January 29, 2021)
Belgium Task Force on Supportive Care and Antiviral/Immunologic Treatment of Hospitalized Patients With Suspected or Confirmed COVID-19 (2020): 2020 interim clinical guidance by the Belgium Task Force for supportive care and antiviral/immunologic therapy for adults with suspected or confirmed coronavirus disease 2019 (COVID-19). (Updated April 2022)
COVID-19 Ventilation Clinical Practice Guidelines (2020): COVID-19 ventilation clinical practice guidelines by the European Society of Intensive Care Medicine and the Society of Critical Care Medicine
Guidance on Obstetric COVID-19 (ISUOG, 2020): Guidance on the management of COVID-19 infection during pregnancy, childbirth, and the neonatal period, from the International Society of Ultrasound in Obstetrics and Gynecology
Control of COVID-19 in Nursing Homes Guidelines (2020): 2020 guidelines on infection control and prevention of COVID-19 in nursing homes by the Centers for Medicare & Medicaid Services (CMS)
FDA Face Mask and Respirator Policy in COVID-19 (2020): 2020 guidelines on enforcement policy for face masks and respirators by the US Food and Drug Administration (FDA)
Rapid COVID-19 Clinical Practice Guidelines (2020): Rapid COVID-19 clinical practice guidelines by Wuhan University Novel Coronavirus Management & Research Team and China International Exchange & Promotive Association for Medical and Health Care.
Guidance on Cardiac Implications of COVID-19 (ACC, 2020): 2020 guidance by the American College of Cardiology regarding the cardiac implications of COVID-19
COVID-19 Guidance for Ophthalmologists (AAO, 2020): 2020 COVID-19 guidance for urgent and nonurgent patient care in ophthalmology.
Guidance on Containing Spread of COVID-19 (CMS, 2020): Guidance for hospitals on how to identify at-risk patients, screen for COVID-19, and monitor or restrict health care facility staff, from the Centers for Medicare & Medicaid Services
COVID-19 Sample Collection and Testing: Clinical Practice Guidelines (CDC, 2020): 2020 clinical practice guidelines from the Centers for Disease Control and Prevention on the collection, handling, and testing of specimens for the diagnosis of coronavirus disease 2019 (COVID-19).
Guidelines for Evaluating and Testing Persons Under Investigation for COVID-19 (CDC, 2020): 2020 clinical practice guidelines on evaluating and testing persons under investigation for coronavirus disease 2019 (COVID-19) by the Centers for Disease Control and Prevention (CDC)
Caring for Children and Youth with Special Health Care Needs During the COVID-19 Pandemic: a 2022 update to the 2020 clinical practice guidelines from the American Academy of Pediatrics provides discussion and resources for parents and caregivers of children with special needs regarding how to minimize infection risk, support from health and related service providers, and school decisions.

Information regarding COVID-19 is rapidly emerging and evolving. For the latest information, see the following:

COVID-19 Terminology and Definitions

There are many different technical and legal terms that have been utilized in official governmental guidance, media reports, and throughout the general public with respect to the 2019-nCoV (2019 Novel Coronavirus) and the resulting COVID-19 (Coronavirus Disease 2019).

Patient Status Definitions

Confirmed: The patient meets all the criteria necessary to be considered a Patient Under Investigation (PUI), including signs, symptoms and travel history. A lab sample was collected and tested by a CDC-qualified laboratory and the result is positive.
Suspected: The patient meets all the criteria necessary to be considered a Patient Under Investigation (PUI), including signs, symptoms and travel history. A lab sample was collected and sent to a CDC-qualified lab, but the results are still pending.
Exposed: The person meets the criteria established by the CDC with regards to travel history and/or close contact with a confirmed case, but the individual is not exhibiting any additional signs or symptoms consistent with infection.

Protective Action Definitions

Treatment: A person is currently receiving active medical treatment for their COVID-19 symptoms and/or related complications.
Isolation: This involves separating ill persons from well persons.
Quarantine: This involves separating well persons, who have been exposed to the infection, from other well persons during the incubation period of an illness.
Monitoring: A state or local public health authority establishes regular communication with a person or group of people who were potentially exposed to the virus by virtue of travel history to identified locations or close contact with confirmed cases. The person is instructed to monitor for and report certain signs and symptoms of potential illness to the health authority. There are no movement restrictions applied to this individual.

Legal Status Definitions

Voluntary: The person has voluntarily agreed to comply with legally enforceable directives issued under the authority of a relevant federal, state, or local entity that, when applied to a person or group, may place restrictions on the activities undertaken by that person or group, potentially including movement restrictions or a requirement for monitoring by a public health authority, for the purposes of protecting the public’s health.
Involuntary: The person has been compelled by a court order to abide by legally enforceable directives issued under the authority of a relevant federal, state, or local entity that, when applied to a person or group, may place restrictions on the activities undertaken by that person or group, potentially including movement restrictions or a requirement for monitoring by a public health authority, for the purposes of protecting the public’s health.
Non-legal: The person is not subject to any legally enforceable directives. The person voluntarily agrees to adhere to non-binding guidance provided by public health or healthcare officials.

Supervision Level Definitions

Direct Medical: The person is under the direct continuous clinical care of a healthcare provider in a clinical setting (e.g. inpatient at a hospital or isolated to a government facility).
Public Health Supervision: The person is monitored directly by local public health authorities, in-person or remotely, on a regular basis (e.g. daily).
Delegated Supervision: The local public health authority has delegated oversight to an appropriate occupational health or infection control program at a trusted organization (e.g. healthcare, higher education, corporation). The delegated supervisor maintains coordination with the public health department of local jurisdiction.
Self: The person is instructed to monitor themselves for and report certain signs and symptoms of potential illness to the healthy authority.

Location Definitions

Hospital: The patient is admitted to a hospital.
Government: The person has been relocated to a government-controlled facility.
Congregate: The person has been relocated to any other congregate type setting (e.g. long term care facility, public housing, university housing) administered by routine operating authorities.

CDC Sample Collection and Testing Guidelines for COVID-19

In March 2020, the CDC published interim guidelines regarding the collection, handling, and testing of clinical specimens for the diagnosis of COVID-19.^[313]

Collection and evaluation of an upper respiratory nasopharyngeal swab (NP) is recommended for initial COVID-19 testing.

If an oropharyngeal swab (OP) is collected, it should be combined in the same tube as the NP; however, OPs are a lower priority than NPs.

Only patients with a productive cough should undergo sputum collection. Sputum induction is not recommended.

If lower respiratory tract specimens are available, they should also be tested.

If clinically indicated (eg, if the patient is undergoing invasive mechanical ventilation), collection and testing of a lower respiratory tract aspirate or bronchoalveolar lavage sample should be performed.

Once a possible COVID-19 case has been identified, specimen collection should be performed as soon as possible, regardless of when the individual’s symptoms began.

Proper infection control must be maintained during specimen collection.

Lower respiratory tract specimens

Bronchoalveolar lavage, tracheal aspirate

Two to 3 mL should be collected in a sterile, leak-proof, screw-cap sputum collection cup or sterile, dry container.

Sputum

The patient should rinse their mouth with water and then expectorate deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile, dry container.

Upper respiratory tract specimens

Nasopharyngeal swab/oropharyngeal swab

Only synthetic fiber swabs with plastic shafts should be used. Calcium alginate swabs or swabs with wooden shafts—both of which may contain substances that inactivate some viruses and inhibit PCR testing—should not be used. Swabs should be placed immediately in sterile tubes containing 2-3 mL of viral transport media. In general, the CDC recommends that only an NP should be collected. If an OP is collected as well, it should be combined at collection with the NP in a single vial.

To collect an NP, the swab should be inserted into the nostril parallel to the palate, reaching a depth equal to the distance from the nostrils to the ear’s outer opening. To absorb secretions, the swab should be left in place for several seconds. It should then be slowly removed while the clinician rotates it.

In collecting an OP (eg, a throat swab), the posterior pharynx should be swabbed, with avoidance of the tongue.

Nasopharyngeal wash/aspirate or nasal aspirate

Two to 3 mL should be collected in a sterile, leak-proof, screw-cap sputum collection cup or sterile, dry container.

Storage

Specimens should be stored at 2-8°C for up to 72 hours after collection. If testing or shipping may be delayed, the specimens should be stored at -70°C or below.

Shipping

Packaging, shipping, and transportation of specimens must be performed as designated in the current edition of the International Air Transport Association (IATA) Dangerous Goods Regulations. Specimens should be stored at 2-8°C and shipped overnight to the CDC on ice pack. Specimens frozen at -70°C should be shipped overnight to the CDC on dry ice.

Guidance for Hospitals on Containing Spread of COVID-19

The guideline on coronavirus disease (COVID-19) infection control and prevention for hospitals was released on March 4, 2020 by the Centers for Medicare & Medicaid Services.^[314]

Hospitals should monitor the CDC website (https://www.cdc.gov/coronavirus/2019-ncov/index.html) for up-to-date information and resources.

Hospitals should contact their local health department if they have questions or suspect a patient or healthcare provider (HCP) has COVID-19.

Hospitals should have plans for monitoring healthcare personnel with exposure to patients with known or suspected COVID-19. Additional information about monitoring healthcare personnel is available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html .

Risk assessment and screening

Older adults and those with underlying chronic medical conditions or immunocompromised state may be at highest risk for severe outcomes. This should be considered in the decision to monitor the patient as an outpatient or inpatient.

Hospitals should identify visitors and patients at risk for having COVID-19 infection before or immediately upon arrival to the healthcare facility. They should ask patients about the following:

Fever or symptoms of a respiratory infection, such as a cough and sore throat
International travel within the last 14 days to restricted countries (For updated information on restricted countries, visit https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html.)
Contact with someone with known or suspected COVID-19

For patients identified as at-risk, implement respiratory hygiene and cough etiquette (ie, placing a face mask over the patient’s nose and mouth) and isolate the patient in an examination room with the door closed.

If the patient cannot be immediately moved to an examination room, ensure they are not allowed to wait among other patients seeking care. Identify a separate, well-ventilated space that allows waiting patients to be separated by 6 or more feet, with easy access to respiratory hygiene supplies. In some settings, medically stable patients might opt to wait in a personal vehicle or outside the healthcare facility where they can be contacted by mobile phone when they can be evaluated.

Inform infection prevention and control services, local and state public health authorities, and other healthcare facility staff as appropriate about the presence of a person under investigation for COVID-19.

Additional guidance for evaluating patients in the United States for COVID-19 can be found on the CDC COVID-19 Web site.

Provide supplies for respiratory hygiene and cough etiquette, including 60%-95% alcohol-based hand sanitizer (ABHS), tissues, no-touch receptacles for disposal, facemasks, and tissues at healthcare facility entrances, waiting rooms, patient check-ins, etc.

Monitoring or restriction of healthcare facility staff

The same screening performed for visitors should be performed for hospital staff.

HCP who have signs and symptoms of a respiratory infection should not report to work.

Any staff that develop signs and symptoms of a respiratory infection while on the job should do the following:

Immediately stop work, put on a facemask, and self-isolate at home.
Inform the hospital’s infection prevention specialist and include information on individuals, equipment, and locations with which the person came into contact.
Contact and follow the local health department recommendations for next steps (eg, testing, locations for treatment).

Refer to the CDC guidance for exposures that might warrant restricting asymptomatic health care personnel from reporting to work (https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html).

Hospitals should contact their local health department for questions and frequently review the CDC website dedicated to COVID-19 for health care professionals: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html.

Patient placement and infection prevention and control for known or suspected COVID-19 cases

Patient placement and other detailed infection prevention and control recommendations regarding hand hygiene, transmission-based precautions, environmental cleaning and disinfection, managing visitors, and monitoring and managing health care personnel are available in the CDC Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons under Investigation for COVID-19 in Healthcare Settings.

Patients may not require hospitalization and can be managed at home if they are able to comply with monitoring requests. More information is available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html.

Patients with known or suspected COVID-19 should continue to receive the intervention appropriate for the severity of their illness and overall clinical condition. Because some procedures create high risks for transmission (eg, intubation), additional precautions include the following:

HCP should wear all recommended personal protective equipment (PPE).
The number of HCP present should be limited to essential personnel.
The room should be cleaned and disinfected in accordance with environmental infection control guidelines.

Additional information about performing aerosol-generating procedures is available at https://www.cdc.gov/coronavirus/2019-ncov/infection-control/controlrecommendations.html.

The decision to discontinue transmission-based precautions for hospitalized patients with COVID-19 should be made on a case-by-case basis in consultation with clinicians, infection prevention and control specialists, and public health officials. This decision should consider disease severity, illness signs and symptoms, and results of laboratory testing for COVID-19 in respiratory specimens.

More detailed information about criteria to discontinue transmission-based precautions are available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html.

Visitation rights

Medicare regulations require a hospital to have written policies and procedures regarding the visitation rights of patients, including those setting forth any clinically necessary or reasonable restriction or limitation that the hospital may need to place on such rights and the reasons for the clinical restriction or limitation, such as infection control concerns.

Patients must be informed of their visitation rights and the clinical restrictions or limitations on visitation.

The development of such policies and procedures require hospitals to focus efforts on preventing and controlling infections, not just between patients and personnel, but also between individuals across the entire hospital setting (for example, among patients, staff, and visitors), as well as between the hospital and other healthcare institutions and settings and between patients and the healthcare environment.

Hospitals should work with their local, state, and federal public health agencies to develop appropriate preparedness and response strategies for communicable threats.

Hospital discharge

The decision to discharge a patient from the hospital should be based on the clinical condition of the patient. If transmission-based precautions must be continued in the subsequent setting, the receiving facility must be able to implement all recommended infection prevention and control measures.

Although patients COVID-19 who have mild symptoms may be managed at home, the decision to discharge to home should take into account the patient’s ability to adhere to isolation recommendations, as well as the potential risk of secondary transmission to household members with immunocompromising conditions.

Medicare’s Discharge Planning Regulations (updated in November 2019) require that the hospital assess the patient’s needs for post-hospital services and the availability of such services. When a patient is discharged, all necessary medical information (including communicable diseases) must be provided to any post-acute service provider. For patients with COVID-19, this must be communicated to the receiving service provider prior to discharge/transfer and to the healthcare transport personnel.

American Academy of Pediatrics Guidance on Management of Infants Born to Mothers with COVID-19

The American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal Perinatal Medicine, and Committee on Infectious Diseases has issued guidance on the management of infants born to mothers with COVID-19.^{[315, 316]}

Early evidence has shown low rates of peripartum SARS-CoV-2 transmission and uncertainty concerning in utero viral transmission.

Neonates can be infected by SARS-CoV-2 after birth. Because of their immature immune systems, they are vulnerable to serious respiratory viral infections. SARS-CoV-2 may be able to cause severe disease in neonates.

Precautions during delivery

A gown and gloves should be worn by birth attendants, along with an N95 respiratory mask plus goggles or an air-purifying respirator that protects the eyes.

Delayed cord clamping

Transplacental viral transmission from mother to newborn has not been clearly demonstrated, so delayed cord clamping can continue per normal center practices. The mother can briefly hold the newborn during delayed cord clamping if infection-control precautions are observed.

Room-in of mother and well newborn

This is controversial. Some information has shown good outcomes among most newborns exposed to mothers with COVID-19, although some infants have developed severe illness. The safest approach is to minimize the infection risk via separation, at least temporarily, allowing time for the mother to become less infectious. If the mother chooses against separation or other factors preclude separation, infection risks should be minimized with distancing (at least 6 feet between mother and newborn) and provision of hands-on care to the infant by a noninfected caregiver. Mothers who provide hands-on care should wear a facemask and observe proper hand hygiene.

Breastfeeding

Breastfeeding is strongly supported as the best choice for infant feeding. Breastmilk is unlikely to transmit SARS-CoV-2. Mothers with COVID-19 may express breast milk after appropriate hand and breast hygiene to be fed to the newborn by caregivers without COVID-19. Mothers who opt for nursing should observe strict precautions, including use of a facemask and breast and hand hygiene.

Neonatal intensive care

If the newborn requires intensive care and respiratory support, admission to a single-patient room with negative room pressure is optimal. If multiple newborns with exposure to COVID-19 must be treated in the same room, they should be kept at least six feet apart and/or kept in temperature-controlled isolettes.

Care providers should wear gowns and gloves, along with an N95 respiratory mask plus goggles or an air-purifying respirator that protects the eyes to treat infants who require supplemental oxygen at more than 2 LPM, continuous positive airway pressure, or mechanical ventilation.

Neonatal testing for COVID-19

Following birth, newborns born to mothers with COVID-19 should be bathed to remove virus from the skin. Newborns should undergo testing for SARS-CoV-2 at 24 hours and 48 hours (if still at the birth facility) after birth. Centers with limited testing resources can make testing decisions on a case-by-case basis.

Newborn discharge

Newborns born to mothers with COVID-19 should be discharged per the hospital’s normal criteria. Early discharge is not necessary.

Newborns who test positive for SARS-CoV-2 but are asymptomatic should undergo frequent outpatient follow-up (via phone, telemedicine, or office visit) through 14 days after birth. Infection-control precautions should be observed at home and in the outpatient office.

Infants who test negative for SARS-CoV-2 are likely to be discharged to the care of individuals who have COVID-19 or who have been exposed to COVID-19. All potential caregivers should receive infection-prevention instructions. Following hospital discharge, mothers with COVID-19 should stay at least 6 feet away from their newborns. If a closer proximity is required, the mother should wear a mask and observe hand hygiene for newborn care until (1) her temperature has normalized for 72 hours without antipyretic therapy and (2) at least 10 days has passed since the onset of symptoms. If the mother has asymptomatic SARS-CoV-2 infection (identified with obstetric screening tests), she should wait at least 10 days from the positive test or until two consecutive tests administered more than 24 hours apart show negative results.

Newborns who cannot undergo SARS-CoV-2 testing should be treated as infected for an observation period of 14 days. The mother should still observe the precautions detailed above.

NICU visitation

Access to NICUs during the COVID-19 pandemic is limited. Mothers and partners with confirmed or suspected COVID-19 (PUIs) should not enter the NICU until their status is resolved and transmission is no longer a risk.

NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines

Pharmacologic management based on COVID-19 disease severity

Outpatient or hospitalized (but not requiring oxygen)

No specific antiviral or immunomodulatory therapy recommended
The Panel recommends against use of dexamethasone
Also see remdesivir for use in hospitalized patients with moderate COVID-19

Hospitalized and requires supplemental oxygen (but not by high-flow device, noninvasive ventilation, invasive mechanical ventilation, or ECMO)

Remdesivir 200 mg IV x 1, then 100 mg IV qDay for 4 days or until hospital discharge, whichever comes first, OR
Remdesivir plus dexamethasone 6 mg IV/PO qDay for up to 10 days or until hospital discharge, whichever comes first
If remdesivir cannot be used, dexamethasone may be used instead

Hospitalized and requires oxygen by high-flow device or noninvasive ventilation

Dexamethasone plus remdesivir at doses and durations above OR
Dexamethasone

Hospitalized and requires invasive mechanical ventilation or ECMO

Dexamethasone at doses and duration above OR
Dexamethasone plus remdesivir for patient recently intubated

Antiviral therapy

Remdesivir

Because remdesivir supplies are limited, the Panel recommends prioritizing remdesivir for use in hospitalized patients with COVID-19 who require supplemental oxygen, but who do not require oxygen delivery by high-flow device, noninvasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

Five days of remdesivir treatment is recommended in hospitalized patients with severe COVID-19 who are not intubated. The optimal duration of remdesivir treatment is undetermined in mechanically ventilated patients, patients on ECMO, and patients in whom improvement is inadequate after 5 days of therapy.

The data are insufficient to recommend for or against remdesivir in patients with mild or moderate COVID-19.

Chloroquine or hydroxychloroquine

The Panel recommends against chloroquine or hydroxychloroquine with or without azithromycin in the treatment of COVID-19 outside the context of a clinical trial.

The Panel recommends against the use of high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19.

Other antivirals

The Panel recommends against (1) hydroxychloroquine plus azithromycin, (2) lopinavir/ritonavir, and (3) other HIV protease inhibitors except in a clinical trial.

Tocilizumab

The Panel recommends use of tocilizumab (single IV dose of 8 mg/kg, up to 800 mg) in combination with dexamethasone in recently hospitalized patients who are exhibiting rapid respiratory decompensation caused by COVID-19. These patients include:

Recently hospitalized patients who have been admitted to the ICU within the prior 24 hours and who require invasive mechanical ventilation, noninvasive mechanical ventilation (NIV), or high-flow nasal canula (HFNC) oxygen (>0.4 FiO2/30 L/min of oxygen flow) (BIIa); or
Recently hospitalized patients (not in the ICU) with rapidly increasing oxygen needs who require NIV or HFNC and have significantly increased markers of inflammation (BIIa) (eg, C-reactive protein 75 mg/L or greater)

Corticosteroids

The Panel recommends dexamethasone (6 mg/day for up to 10 days) in patients with COVID-19 who are mechanically ventilated and in patients who require supplemental oxygen but are not mechanically ventilated.

The Panel recommends against dexamethasone in patients with COVID-19 who do not require supplemental oxygen.

If dexamethasone is not available, the Panel recommends using alternative glucocorticoids such as prednisone, methylprednisolone, or hydrocortisone.

Convalescent plasma

The FDA granted emergency use authorization (EUA) on August 23, 2020 for use of convalescent plasma in hospitalized patients with COVID-19. Convalescent plasma contains antibody-rich plasma products collected from eligible donors who have recovered from COVID-19.

The NIH COVID-19 Guidelines Panel further evaluated the Mayo Clinic’s expanded access (EA) program data and further reviewed subgroups. Among patients who were not intubated, 11% of those who received convalescent plasma with high antibody titers died within 7 days of transfusion compared with 14% of those who received convalescent plasma with low antibody titers. Among those who were intubated, there was no difference in 7-day survival.

Based on the available evidence, the panel determined the following^[250]:

There are insufficient data to recommend either for or against the use of convalescent plasma for the treatment of COVID-19.
Adverse effects of COVID-19 convalescent plasma are infrequent and consistent with the risks associated with plasma infusions for other indications.
Convalescent plasma should not be considered standard of care for the treatment of patients with COVID-19.
Prospective, well-controlled, adequately powered, randomized trials are needed.

The NIH halted its trial of convalescent plasma in emergency departments for treatment of patients with mild symptoms as of March 2021. The second planned interim analysis of the trial data determined that while the convalescent plasma intervention caused no harm, it was unlikely to benefit this group of patients.

NIH COVID-19 Treatment Guidelines^[317]

Care of Critically Ill Patients with COVID-19

Potential Antiviral Drugs Under Evaluation for the Treatment of COVID-19

Immune-Based Therapy Under Evaluation for Treatment of COVID-19

Considerations for certain Concomitant Medications in Patients with COVID-19

Infectious Diseases Society of America (IDSA) Management Guidelines

The Infectious Diseases Society of America (IDSA) has formed a multidisciplinary guideline panel to provide treatment recommendations for coronavirus disease 2019 (COVID-19).^[26] Refer to the IDSA guidelines for the most recent version.

Antivirals

Remdesivir

Remdesivir is approved the FDA for treatment of COVID-19 in hospitalized adults and pediatric patients aged 12 years and older who weigh at least 40 kg.
Emergency use authorization (EUA) has also been issued for use in hospitalized children aged 12 years or younger weighing 3.5 kg to less than 40 kg.
Consideration in contingency or crisis capacity settings (ie, limited remdesivir supply): Remdesivir appears to demonstrate the most benefit in those with severe COVID-19 on supplemental oxygen rather than in patients on mechanical ventilation or ECMO.

Ivermectin

Insufficient data exist to recommend.
Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19, in either ambulatory or hospitalized patients.

Strong recommendation against use

Hydroxychloroquine or chloroquine with or without azithromycin: In patients with COVID-19, the panel recommends against hydroxychloroquine/chloroquine. Strong recommendation, moderate certainty of evidence.
Lopinavir/ritonavir and other HIV protease inhibitors
Hydroxychloroquine/chloroquine plus azithromycin: In patients with COVID-19, the panel suggests against hydroxychloroquine/chloroquine plus azithromycin. Strong recommendation, low certainty of evidence.
Combination of lopinavir/ritonavir: In hospitalized patients with severe COVID-19, the panel recommends against the combination of lopinavir/ritonavir. Strong recommendation, moderate certainty of evidence.

Corticosteroids

Corticosteroids used in patients with COVID-19 include the following:

Hospitalized critically ill patients: The panel recommends glucocorticoids over no glucocorticoids (dexamethasone 6 mg IV or PO for 10 days, or until discharge). Strong recommendation, moderate certainty of evidence.
Hospitalized patients with severe, but noncritical COVID-19: The panel suggests corticosteroids rather than no corticosteroids. Conditional recommendation, moderate certainty of evidence.
Hospitalized patients with nonsevere COVID-19: The Panel suggests against use of glucocorticoids. Conditional recommendation, low certainty of evidence.

Immunomodulators

Baricitinib

Among hospitalized adults with severe COVID-19 having elevated inflammatory markers, but not on invasive mechanical ventilation, the IDSA panel suggests baricitinib rather than no baricitinib.
Among hospitalized patients with severe COVID-19 who cannot receive corticosteroids because of a contraindication, the IDSA guideline panel suggests use of baricitinib with remdesivir rather than remdesivir alone.
The FDA issued and EUA for baricitinib for use in combination with remdesivir for treatment of COVID-19 in hospitalized patients aged 2 years and older who require supplemental oxygen, invasive mechanical ventilation, or ECMO.

Tocilizumab and other IL-6 inhibitors

Tocilizumab: In hospitalized adults with COVID-19 who have elevated markers of systemic inflammation, the panel suggests tocilizumab in addition to standard of care (ie, steroids) rather than standard of care alone. Conditional recommendation, low certainty of evidence.
Sarilumab: Preliminary data (preprint) from a trial with 45 patients receiving sarilumab; data are limited to offer recommendation.

Anti-SARS-CoV-2 antibody products

Monoclonal directed antibodies

The FDA issued EUAs for nonhospitalized patients with mild-to-moderate COVID-19 disease who are at high risk of disease progression.
Consider local variant susceptibility when choosing of the most appropriate neutralizing antibody therapy.

Convalescent plasma

The FDA issued an EUA for use in hospitalized patients.
Hospitalized patients: IDSA guideline panel suggests against COVID-19 convalescent plasma (low certainty of evidence).
Ambulatory patients with mild-to-moderate disease: IDSA guideline panel recommends COVID-19 convalescent plasma only in the context of a clinical trial (knowledge gap)

Famotidine

Famotidine may also be administered to patients with COVID-19, as follows:

In hospitalized patients with severe COVID-19, the panel suggests against famotidine for the sole intent of COVID-19 treatment outside the context of a clinical trial
Conditional recommendation, very low certainty of evidence.

Thromboembolism Prevention and Treatment

American College of Chest Physicians

Guideline summary is as follows^[318]:

In the absence of contraindications, all acutely hospitalized patients with COVID-19 should receive thromboprophylaxis therapy.
Low-molecular-weight heparin (LMWH) or fondaparinux should be used for thromboprophylaxis over unfractionated heparin and direct oral anticoagulants.
Data are insufficient to justify routine increased-intensity anticoagulant dosing in hospitalized or critically ill patients with COVID-19.
Recommend only inpatient thromboprophylaxis for patients with COVID-19.
In critically ill patients with COVID-19, suggest against routine ultrasonographic screening for asymptomatic deep vein thrombosis (DVT).
In critically ill patients with COVID-19 who have proximal DVT or pulmonary embolism, recommend parenteral anticoagulation therapy with therapeutic weight-adjusted LMWH or fondaparinux over unfractionated heparin.

International Society on Thrombosis and Haemostasis

Guideline summary is as follows^[319]:

In hospitalized patients, measure D-dimers, prothrombin time, and platelet count (and possibly fibrinogen).
The guidelines include an algorithm for management of coagulopathy based on laboratory markers.
Monitoring for septic coagulopathy can be helpful in determining prognosis in patients with COVID‐19 requiring hospital admission.
Use of LMWH to protect critically ill patients against venous thromboembolism appears to improve prognosis.

National Institutes of Health Antithrombotic Therapy in Patients with COVID-19

Guideline summary is as follows^[320]:

Measure hematologic and coagulation parameters (eg, D-dimers, PT, platelet count, fibrinogen) in hospitalized patients.
Patients on anticoagulant or antiplatelet therapies for underlying conditions should continue these medications if they receive a diagnosis of COVID-19.
Hospitalized adults with COVID-19 should receive VTE prophylaxis per the standard of care for other hospitalized adults, unless contraindicated.
Hospitalized patients with COVID-19 should not routinely be discharged on VTE prophylaxis.
In hospitalized patients, the possibility of thromboembolic disease should be evaluated in the event of rapid deterioration of pulmonary, cardiac, or neurological function or of sudden localized loss of peripheral perfusion.
Nonhospitalized patients with COVID-19: Anticoagulants and antiplatelet therapy should not be initiated for prevention of VTE or arterial thrombosis unless the patient has other indications for the therapy or is participating in a clinical trial.

Medication

CDC. 2019 Novel Coronavirus, Wuhan, China. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/about/index.html. January 26, 2020; Accessed: December 1, 2021.
Gallegos A. WHO Declares Public Health Emergency for Novel Coronavirus. Medscape Medical News. Available at https://www.medscape.com/viewarticle/924596. January 30, 2020; Accessed: December 1, 2021.
Ramzy A, McNeil DG. W.H.O. Declares Global Emergency as Wuhan Coronavirus Spreads. The New York Times. Available at https://nyti.ms/2RER70M. January 30, 2020; Accessed: December 1, 2021.
The New York Times. Coronavirus Live Updates: W.H.O. Declares Pandemic as Number of Infected Countries Grows. The New York Times. Available at https://www.nytimes.com/2020/03/11/world/coronavirus-news.html#link-682e5b06. March 11, 2020; Accessed: December 1, 2021.
Coronavirus Updates: The Illness Now Has a Name: COVID-19. The New York Times. Available at https://www.nytimes.com/2020/02/11/world/asia/coronavirus-china.html. February 11, 2020; Accessed: December 1, 2021.
WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. Available at https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. February 11, 2020; Accessed: December 1, 2021.
Gorbalenya AE. Severe acute respiratory syndrome-related coronavirus – The species and its viruses, a statement of the Coronavirus Study Group. Available at https://read.qxmd.com/doi/10.1101/2020.02.07.937862. February 11, 2020; Accessed: December 1, 2021.
CDC COVID-19 Response Team, Jorden MA, Rudman SL, et al. Evidence for Limited Early Spread of COVID-19 Within the United States, January-February 2020. MMWR. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments. May 29, 2020; Accessed: December 1, 2021.
CDC. Coronavirus Disease 2019 (COVID-19): Recommendations for Cloth Face Covers. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html. April 3, 2020; Accessed: December 1, 2021.
Ferguson NM, Laydon D, Nedjati-Gilani G, Imai N, Ainslie K, Baguelin M, et al. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College COVID-19 Response Team. Available at https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf. 2020 Mar 16; Accessed: December 1, 2021.
Christie A, Brooks JT, Hicks LA, et al. Guidance for Implementing COVID-19 Prevention Strategies in the Context of Varying Community Transmission Levels and Vaccination Coverage. MMWR Morb Mortal Wkly Rep. 2021. 70:1044–1047. [Full Text].
Honein MA, Christie A, Rose DA, et al. Summary of guidance for public health strategies to address high levels of community transmission of SARS-CoV-2 and related deaths, December 2020. MMWR Morb Mortal Wkly Rep. 2020 Dec 04. [Full Text].
Centers for Disease Control and Prevention. How to Protect Yourself & Others. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. November 29, 2021; Accessed: December 1, 2021.
CDC. Underlying medical conditions associated with high risk for severe COVID-19: Information for healthcare providers. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html. 2021 Mar 29; Accessed: December 1, 2021.
Tanaka H, Ogata T, Shibata T, Nagai H, Takahashi Y, Kinoshita M, et al. Shorter Incubation Period among COVID-19 Cases with the BA.1 Omicron Variant. Int J Environ Res Public Health. 2022 May 23. 19 (10):[QxMD MEDLINE Link].
Clinical characteristics of COVID-19. European Centre for Disease Prevention and Control. Available at https://www.ecdc.europa.eu/en/covid-19/latest-evidence/clinical. Accessed: 4/29/2022.
Hentsch L, Cocetta S, Allali G, Santana I, Eason R, Adam E, et al. Breathlessness and COVID-19: A Call for Research. Respiration. 2021. 100 (10):1016-1026. [QxMD MEDLINE Link].
Zoghi G, Moosavy SH, Yavarian S, HasaniAzad M, Khorrami F, Sharegi Brojeni M, et al. Gastrointestinal implications in COVID-19. BMC Infect Dis. 2021 Nov 4. 21 (1):1135. [QxMD MEDLINE Link].
Rabin RC. Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection. The New York Times. Available at https://www.nytimes.com/2020/03/22/health/coronavirus-symptoms-smell-taste.html. March 22, 2020; Accessed: December 1, 2021.
Coelho DH, Reiter ER, French E, Costanzo RM. Decreasing Incidence of Chemosensory Changes by COVID-19 Variant. Otolaryngol Head Neck Surg. 2022 May 3. 1945998221097656. [QxMD MEDLINE Link].
CDC. 2019 Novel Coronavirus, Wuhan, China: Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/infection-control.html. January 18, 2020; Accessed: December 1, 2021.
Rizk JG, Forthal DN, Kalantar-Zadeh K, Mehra MR, Lavie CJ, Rizk Y, et al. Expanded Access Programs, compassionate drug use, and Emergency Use Authorizations during the COVID-19 pandemic. Drug Discov Today. 2020 Nov 27. [QxMD MEDLINE Link]. [Full Text].
FDA. FDA Approves First Treatment for COVID-19. FDA.gov. 2020 Oct 22. Available at https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-covid-19.
Veklury (remdesivir) [package insert]. Foster City, CA: Gilead Sciences, Inc. June 2022. Available at [Full Text].
RECOVERY Collaborative Group., Horby P, Lim WS, Emberson JR, et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021 Feb 25. 384 (8):693-704. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. IDSA. Available at https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/. 2021 Oct 01; Accessed: October 6, 2021.
McCreary EK, Pogue JM. COVID-19 Treatment: A Review of Early and Emerging Options. Open Forum Infectious Diseases (OFID). 2020 Mar 23. [Full Text].
Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020 Apr 13. [QxMD MEDLINE Link]. [Full Text].
Barlow A, Landolf KM, Barlow B, Yeung SYA, Heavner JJ, Claassen CW, et al. Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019. Pharmacotherapy. 2020 Apr 7. [QxMD MEDLINE Link]. [Full Text].
Jomah S, Asdaq SMB, Al-Yamani MJ. Clinical efficacy of antivirals against novel coronavirus (COVID-19): A review. J Infect Public Health. 2020 Aug 3. [QxMD MEDLINE Link]. [Full Text].
Abutaleb Y. How the new coronavirus differs from SARS, measles and Ebola. The Washington Post. Available at https://www.washingtonpost.com/health/how-the-new-coronavirus-differs-from-sars-measles-and-ebola/2020/01/23/aac6bb06-3e1b-11ea-b90d-5652806c3b3a_story.html. January 23, 2020; Accessed: December 1, 2021.
World Health Organization. MERS situation update, February 2022. WHO Regional Office for the Eastern Mediterranean. Available at http://www.emro.who.int/health-topics/mers-cov/mers-outbreaks.html. February 2022; Accessed: May 17, 2022.
Handiso TB, Jifar MS, Nuriye Hagisso S. Coronavirus's (SARS-CoV-2) airborne transmission. SAGE Open Med. 2022. 10:20503121221094185. [QxMD MEDLINE Link].
Centers for Disease Control and Prevention. COVID-19 Overview and Infection Prevention and Control Priorities in non-U.S. Healthcare Settings. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/overview/index.html. Updated May 7, 2021; Accessed: June 17, 2022.
CDC. Coronavirus Disease 2019: Scientific Brief: SARS-CoV-2 and Potential Airborne Transmission. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html. 2020 Oct 05; Accessed: December 1, 2021.
Morawska L, Milton DK. It is Time to Address Airborne Transmission of COVID-19. Clin Infect Dis. 2020 Jul 6. [QxMD MEDLINE Link].
Mask use in the context of COVID-19 (1 December 2020). World Health Organization. Available at https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak. December 1, 2020; Accessed: May 17, 2022.
World Health Organization. Roadmap to improve and ensure good indoor ventilation in COVID-19 context (1 March 2021). World Health Organization. Available at https://www.who.int/publications/i/item/9789240021280. March 1, 2021; Accessed: May 17, 2022.
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020 Mar 17. [QxMD MEDLINE Link].
Chin AWH, Chu JTS, Perera MRA, et al. Stability of SARS-CoV-2 in different environmental conditions. The Lancet Microbe. April 2, 2020. [Full Text].
Rahmani A, Dini G, Leso V, Montecucco A, Kusznir Vitturi B, Iavicoli I, et al. Duration of SARS-CoV-2 shedding and infectivity in the working age population: a systematic review and meta-analysis. Med Lav. 2022 Apr 26. 113 (2):e2022014. [QxMD MEDLINE Link].
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 11. [QxMD MEDLINE Link].
Liu Y, Yan LM, Wan L, Xiang TX, Le A, Liu JM, et al. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis. 2020 Mar 19. [QxMD MEDLINE Link].
Zhou B, She J, Wang Y, Ma X. The duration of viral shedding of discharged patients with severe COVID-19. Clin Infect Dis. 2020 Apr 17. [QxMD MEDLINE Link].
Mole B. Recovered COVID-19 patients test positive but not infectious, data finds. Ars Technica. Available at https://arstechnica.com/science/2020/05/feared-reactivation-of-covid-19-infections-disputed-by-new-data/. May 19, 2020; Accessed: December 1, 2021.
Aydillo T, Gonzalez-Reiche AS, Aslam S, van de Guchte A, Khan Z, Obla A, et al. Shedding of Viable SARS-CoV-2 after Immunosuppressive Therapy for Cancer. N Engl J Med. 2020 Dec 24. 383 (26):2586-2588. [QxMD MEDLINE Link]. [Full Text].
Baang JH, Smith C, Mirabelli C, Valesano AL, Manthei DM, Bachman M, et al. Prolonged SARS-CoV-2 replication in an immunocompromised patient. J Infect Dis. 2020 Oct 22. [QxMD MEDLINE Link]. [Full Text].
Li D, Jin M, Bao P, Zhao W, Zhang S. Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019. JAMA Netw Open. 2020 May 1. 3 (5):e208292. [QxMD MEDLINE Link].
Oran DP, Topol EJ. Prevalence of Asymptomatic SARS-CoV-2 Infection : A Narrative Review. Ann Intern Med. 2020 Sep 1. 173 (5):362-367. [QxMD MEDLINE Link]. [Full Text].
Johansson MA, Quandelacy TM, Kada S, Prasad PV, Steele M, Brooks JT, et al. SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. JAMA Netw Open. 2021 Jan 4. 4 (1):e2035057. [QxMD MEDLINE Link]. [Full Text].
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020 Feb 19. [QxMD MEDLINE Link].
WHO Coronavirus Disease (COVID-19) Dashboard. World Health Organization. Available at https://covid19.who.int/. 2023 Apr 05; Accessed: April 5, 2023.
CDC. Coronavirus Disease 2019 (COVID-19) – Cases in the U.S. Centers for Disease Control and Prevention (CDC). Available at https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days. 2023 Mar 29; Accessed: April 5, 2023.
Ahmad FB, Cisewski JA, Miniño A, Anderson RN. Provisional Mortality Data - United States, 2020. MMWR Morb Mortal Wkly Rep. 2021 Apr 9. 70 (14):519-522. [QxMD MEDLINE Link]. [Full Text].
Ahmad FB, Cisewski JA, Anderson RN. Provisional Mortality Data - United States, 2021. MMWR Morb Mortal Wkly Rep. 2022 Apr 29. 71 (17):597-600. [QxMD MEDLINE Link]. [Full Text].
Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med. 2020 Jun 25. 382 (26):2534-2543. [QxMD MEDLINE Link]. [Full Text].
Khanijahani A, Iezadi S, Gholipour K, Azami-Aghdash S, Naghibi D. A systematic review of racial/ethnic and socioeconomic disparities in COVID-19. Int J Equity Health. 2021 Nov 24. 20 (1):248. [QxMD MEDLINE Link].
Zelner J, Trangucci R, Naraharisetti R, Cao A, Malosh R, Broen K, et al. Racial disparities in COVID-19 mortality are driven by unequal infection risks. Clin Infect Dis. 2020 Nov 21. [QxMD MEDLINE Link]. [Full Text].
Tai DBG, Shah A, Doubeni CA, Sia IG, Wieland ML. The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Clin Infect Dis. 2020 Jun 20. [QxMD MEDLINE Link]. [Full Text].
Millet C, Racoosin E, Narvar S, Horani G, et al. The Racial Divide: A Follow Up Study on Racial Disparity Amongst COVID-19 Survivors in an Urban Community. J Community Hosp Intern Med Perspect. 2022 May 2. 12(3):66-70. [QxMD MEDLINE Link]. [Full Text].
Hobbs CV, Kim SS, Vemula P, Inagaki K, et al. Active Surveillance With Seroprevalence-based Infection Rates Indicates Racial Disparities With Pediatric SARS-CoV-2 Requiring Hospitalization in Mississippi, March 2020-February 2021. Pediatr Infect Dis J. 2022 Jun 7. [QxMD MEDLINE Link].
Ward LA, Black KP, Britton CL, Tompkins ML, Provost EM. COVID-19 Cases, Hospitalizations, and Deaths Among American Indian or Alaska Native Persons - Alaska, 2020-2021. MMWR Morb Mortal Wkly Rep. 2022 Jun 3. 71 (22):730-733. [QxMD MEDLINE Link].
Cunningham JW, Vaduganathan M, Claggett BL, Jering KS, Bhatt AS, Rosenthal N, et al. Clinical Outcomes in Young US Adults Hospitalized With COVID-19. JAMA Intern Med. 2020 Sep 9. [QxMD MEDLINE Link]. [Full Text].
Park YJ, Choe YJ, Park O, and the, COVID-19 National Emergency Response Center, Epidemiology and Case Management Team. Contact Tracing during Coronavirus Disease Outbreak, South Korea, 2020. Emerg Infect Dis. 2020 Oct. 26 (10):2465-2468. [QxMD MEDLINE Link]. [Full Text].
Schwartz NG, Moorman AC, Makaretz A, Chang KT, Chu VT, Szablewski CM, et al. Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering - Four States, June-July 2020. MMWR Morb Mortal Wkly Rep. 2020 Oct 9. 69 (40):1457-1459. [QxMD MEDLINE Link]. [Full Text].
Zhu F, Ang JY. COVID-19 Infection in Children: Diagnosis and Management. Curr Infect Dis Rep. 2022 Apr 11. 1-12. [QxMD MEDLINE Link].
Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents: A Systematic Review. JAMA Pediatr. 2020 Apr 22. [QxMD MEDLINE Link].
Aronoff SC, Hall A, Del Vecchio MT. The Natural History of SARS-Cov-2 Related Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review. J Pediatric Infect Dis Soc. 2020 Sep 14. [QxMD MEDLINE Link]. [Full Text].
Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine. 2020 Jul. 24:100433. [QxMD MEDLINE Link]. [Full Text].
Ahmed M, Advani S, Moreira A, Zoretic S, Martinez J, Chorath K, et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine. 2020 Sep 4. 100527. [QxMD MEDLINE Link]. [Full Text].
Children and COVID-19: State-Level Data Report. American Academy of Pediatrics. Available at https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/. 2022 Oct 27; Accessed: November 7, 2022.
Hillis SD, Blenkinsop A, Villaveces A, Annor FB, Liburd L, Massetti GM, et al. COVID-19-Associated Orphanhood and Caregiver Death in the United States. Pediatrics. 2021 Oct 7. [QxMD MEDLINE Link]. [Full Text].
CDC. COVID Data Tracker. Centers for Disease Control and Prevention. Available at https://covid.cdc.gov/covid-data-tracker/#datatracker-home. June 16, 2022; Accessed: June 17, 2022.
Bixler D, Miller AD, Mattison CP, and the, Pediatric Mortality Investigation Team. SARS-CoV-2-Associated Deaths Among Persons Aged MMWR Morb Mortal Wkly Rep</i>. 2020 Sep 18. 69 (37):1324-1329. [QxMD MEDLINE Link]. [Full Text].
Chao JY, Derespina KR, Herold BC, Goldman DL, Aldrich M, Weingarten J, et al. Clinical Characteristics and Outcomes of Hospitalized and Critically Ill Children and Adolescents with Coronavirus Disease 2019 at a Tertiary Care Medical Center in New York City. J Pediatr. 2020 Aug. 223:14-19.e2. [QxMD MEDLINE Link]. [Full Text].
Han MS, Choi EH, Chang SH, Jin BL, Lee EJ, Kim BN, et al. Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea. JAMA Pediatr. 2020 Aug 28. [QxMD MEDLINE Link]. [Full Text].
Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K, et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020 Nov. 20 (11):e276-e288. [QxMD MEDLINE Link].
Feldstein LR, Tenforde MW, Friedman KG, and the, Overcoming COVID-19 Investigators. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. JAMA. 2021 Feb 24. [QxMD MEDLINE Link]. [Full Text].
Ko JY, DeSisto CL, Simeone RM, Ellington S, Galang RR, Oduyebo T, et al. Adverse Pregnancy Outcomes, Maternal Complications, and Severe Illness Among US Delivery Hospitalizations With and Without a Coronavirus Disease 2019 (COVID-19) Diagnosis. Clin Infect Dis. 2021 Jul 15. 73 (Suppl 1):S24-S31. [QxMD MEDLINE Link]. [Full Text].
Wang H, Li N, Sun C, Guo X, Su W, Song Q, et al. The association between pregnancy and COVID-19: A systematic review and meta-analysis. Am J Emerg Med. 2022 Apr 6. 56:188-195. [QxMD MEDLINE Link].
Ayala-Ramírez P, González M, Escudero C, Quintero-Arciniegas L, Giachini FR, Alves de Freitas R, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy. A Non-systematic Review of Clinical Presentation, Potential Effects of Physiological Adaptations in Pregnancy, and Placental Vascular Alterations. Front Physiol. 2022. 13:785274. [QxMD MEDLINE Link].
DeSisto CL, Wallace B, Simeone RM, Polen K, Ko JY, Meaney-Delman D, et al. Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization - United States, March 2020-September 2021. MMWR Morb Mortal Wkly Rep. 2021 Nov 26. 70 (47):1640-1645. [QxMD MEDLINE Link]. [Full Text].
Marín Gabriel MA, Reyne Vergeli M, Caserío Carbonero S, Sole L, Carrizosa Molina T, Rivero Calle I, et al. Maternal, Perinatal and Neonatal Outcomes With COVID-19: A Multicenter Study of 242 Pregnancies and Their 248 Infant Newborns During Their First Month of Life. Pediatr Infect Dis J. 2020 Sep 11. [QxMD MEDLINE Link].
Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM. 2020 Aug. 2 (3):100134. [QxMD MEDLINE Link]. [Full Text].
Adhikari EH, Moreno W, Zofkie AC, MacDonald L, McIntire DD, Collins RRJ, et al. Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA Netw Open. 2020 Nov 2. 3 (11):e2029256. [QxMD MEDLINE Link].
Chambers C, Krogstad P, Bertrand K, Contreras D, Tobin NH, Bode L, et al. Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women. JAMA. 2020 Aug 19. [QxMD MEDLINE Link]. [Full Text].
Pace RM, Williams JE, Järvinen KM, Meehan CL, Martin MA, Ley SH, et al. Milk From Women Diagnosed With COVID-19 Does Not Contain SARS-CoV-2 RNA but Has Persistent Levels of SARS-CoV-2-Specific IgA Antibodies. Front Immunol. 2021. 12:801797. [QxMD MEDLINE Link]. [Full Text].
Dandachi D, Geiger G, Montgomery MW, and the, HIV-COVID-19 consortium. Characteristics, Comorbidities, and Outcomes in a Multicenter Registry of Patients with HIV and Coronavirus Disease-19. Clin Infect Dis. 2020 Sep 9. [QxMD MEDLINE Link]. [Full Text].
Okoh AK, Bishburg E, Grinberg S, Nagarakanti S. COVID-19 Pneumonia in Patients With HIV: A Case Series. J Acquir Immune Defic Syndr. 2020 Sep 1. 85 (1):e4-e5. [QxMD MEDLINE Link]. [Full Text].
Karmen-Tuohy S, Carlucci PM, Zervou FN, Zacharioudakis IM, Rebick G, Klein E, et al. Outcomes Among HIV-Positive Patients Hospitalized With COVID-19. J Acquir Immune Defic Syndr. 2020 Sep 1. 85 (1):6-10. [QxMD MEDLINE Link]. [Full Text].
Ho HE, Peluso MJ, Margus C, Matias Lopes JP, He C, Gaisa MM, et al. Clinical outcomes and immunologic characteristics of Covid-19 in people with HIV. J Infect Dis. 2020 Jun 30. [QxMD MEDLINE Link]. [Full Text].
Oyelade T, Alqahtani JS, Hjazi AM, Li A, Kamila A, Raya RP. Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis. Trop Med Infect Dis. 2022 Feb 3. 7 (2):[QxMD MEDLINE Link].
Self WH, Tenforde MW, Stubblefield WB, and the, CDC COVID-19 Response Team IVY Network. Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network – 13 academic medical centers, April-June 2020. MMWR Morb Mortal Wkly Rep. 2020 Aug 31. 69:[Full Text].
Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020 Aug 13. [QxMD MEDLINE Link]. [Full Text].
O'Hearn M, Liu J, Cudhea F, Micha R, Mozaffarian D. Coronavirus Disease 2019 Hospitalizations Attributable to Cardiometabolic Conditions in the United States: A Comparative Risk Assessment Analysis. J Am Heart Assoc. 2021 Feb. 10 (5):e019259. [QxMD MEDLINE Link]. [Full Text].
Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020 Jan 14. 91:264-266. [QxMD MEDLINE Link].
Vangeel L, De Jonghe S, Maes P, Slechten B, Raymenants J, André E, et al. Remdesivir, molnupiravir and nirmatrelvir remain active against SARS-CoV-2 omicron and other variants of concern. bioRxiv. 2021 Dec 28. [Full Text].
Pulliam JRC, van Schalkwyk C, Govender N, von Gottberg A, Cohen C, Groome MJ, et al. Increased risk of SARS-CoV-2 reinfection associated with emergence of the Omicron variant in South Africa. medRxiv. 2021 Dec 02. [Full Text].
Wilhelm A, Widera M, Grikscheit K, Toptan T, Schenk B, Pallas C, et al. Reduced neutralization of SARS-CoV-2 omicron variant by vaccine sera and monoclonal antibodies. medRxiv. 2021 Dec 13. [Full Text].
Cherian S, Potdar V, Jadhav S, Yadav P, Gupta N, Das M, et al. Convergent evolution of SARS-CoV-2 spike mutations, L452R, E484Q and P681R, in the second wave of COVID-19 in Maharashtra, India. bioRxiv. 2021 May 03. [Full Text].
Edara VV, Lai L, Sahoo MK, Floyd K, Sibai M, Solis D, et al. Infection and vaccine-induced neutralizing antibody responses to the SARS-CoV-2 B.1.617.1 variant. bioRxiv. 2021 May 10. [Full Text].
Lopez Bernal J, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S, et al. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. 2021 Jul 21. [QxMD MEDLINE Link]. [Full Text].
Volz E, Mishra S, Chand M, Barrett JC, Johnson R, Geidelberg L, et al. Report 42 - Transmission of SARS-CoV-2 Lineage B.1.1.7 in England: Insights from linking epidemiological and genetic data. Imperial College London, MRC Centre for Global Infectious Disease Analysis. Available at https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-12-31-COVID19-Report-42-Preprint-VOC.pdf. 2020 Dec 31; Accessed: December 1, 2021.
Nelson G, Oleksandr B, Spilman P, Niazi K, Rabizadeh S, Soon-Shiong P. Molecular dynamic simulation reveals E484K mutation enhances spike RBD-ACE2 affinity and the combination of E484K, K417N and N401Y mutations (501Y.V2 variant) induces conformational change greater than N401Y mutant alone, potentially resulting in an escape mutant. bioRxiv. 2021 Jan 13. [Full Text].
Sabino EC, Buss LF, Carvalho MPS, Prete CA, Crispim MAE, Fraiji NA, et al. Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence. Lancet. 2021 Jan 27. [Full Text].
CDC. Symptoms of Coronavirus. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. May 13, 2020 (updated March 22, 2022); Accessed: April 29, 2022.
Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med. 2020 Mar 10. [QxMD MEDLINE Link].
Deo R, Choudhary MC, Moser C, and the, ACTIV-2/A5401 Study Team†. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection. Ann Intern Med. 2023 Feb 21. [QxMD MEDLINE Link]. [Full Text].
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24. [QxMD MEDLINE Link].
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020 Aug 25. 324 (8):782-793. [QxMD MEDLINE Link].
Burke RM, Killerby ME, Newton S, Ashworth CE, Berns AL, Brennan S, et al. Symptom Profiles of a Convenience Sample of Patients with COVID-19 - United States, January-April 2020. MMWR Morb Mortal Wkly Rep. 2020 Jul 17. 69 (28):904-908. [QxMD MEDLINE Link].
CDC. Healthcare Workers: Information on COVID-19. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html. March 31, 2021 (updated); Accessed: December 1, 2021.
Williamson EJ, Walker AJ, Bhaskaran K, et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature. 2020 Jul 8. [QxMD MEDLINE Link].
Hewitt J, Carter B, Vilches-Moraga A, et al. The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study. Lancet Public Health. 2020 Jun 30. [QxMD MEDLINE Link].
Ellinghaus D, Degenhardt F, Bujanda L, et al. The ABO blood group locus and a chromosome 3 gene cluster associate with SARS-CoV-2 respiratory failure in an Italian-Spanish genome-wide association analysis. medRxiv. Available at https://www.medrxiv.org/content/10.1101/2020.05.31.20114991v1. June 2, 2020; Accessed: December 1, 2021.
Ellinghaus D, Degenhardt F, Bujanda L, et al. Genomewide Association Study of Severe Covid-19 With Respiratory Failure. NEJM. 2020 Jun 17. [QxMD MEDLINE Link]. [Full Text].
Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C, et al. Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection. JAMA. 2020 Apr 22. [QxMD MEDLINE Link].
Luers JC, Rokohl AC, Loreck N, Wawer Matos PA, Augustin M, Dewald F, et al. Olfactory and Gustatory Dysfunction in Coronavirus Disease 19 (COVID-19). Clin Infect Dis. 2020 May 1. [QxMD MEDLINE Link].
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Jan 24. [QxMD MEDLINE Link].
Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Feb 28. [QxMD MEDLINE Link].
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15. 395 (10223):507-513. [QxMD MEDLINE Link].
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Feb 7. [QxMD MEDLINE Link].
CDC. Long-Term Effects of COVID-19. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. 2020 Nov 13; Accessed: December 1, 2021.
[Guideline] COVID-19 Treatment Guidelines Panel. Clinical Spectrum of SARS-CoV-2 Infection. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/. October 19, 2021 (updated); Accessed: December 1, 2021.
[Guideline] COVID-19 rapid guideline: managing the long-term effects of COVID-19. National Institute for Health and Care Excellence (NICE). Available at https://www.nice.org.uk/guidance/NG188. 2020 Dec 18; Accessed: December 1, 2021.
Datta SD, Talwar A, Lee JT. A Proposed Framework and Timeline of the Spectrum of Disease Due to SARS-CoV-2 Infection: Illness Beyond Acute Infection and Public Health Implications. JAMA. 2020 Dec 8. 324 (22):2251-2252. [QxMD MEDLINE Link]. [Full Text].
McFadyen JD, Stevens H, Peter K. The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications. Circ Res. 2020 Jul 31. 127 (4):571-587. [QxMD MEDLINE Link]. [Full Text].
Kotecha T, Knight DS, Razvi Y, Kumar K, Vimalesvaran K, Thornton G, et al. Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance. Eur Heart J. 2021 Feb 18. [QxMD MEDLINE Link]. [Full Text].
Sciscent BY, Eisele CD, Ho L, King SD, Jain R, Golamari RR. COVID-19 reinfection: the role of natural immunity, vaccines, and variants. J Community Hosp Intern Med Perspect. 2021. 11 (6):733-739. [QxMD MEDLINE Link].
Pérez-Lago L, Kestler M, Sola-Campoy PJ, et al. SARS-CoV-2 superinfection and reinfection with three different strains. Transbound Emerg Dis. 2021 Oct 23. [QxMD MEDLINE Link].
CDC. 2019 Novel Coronavirus, Wuhan, China: Frequently Asked Questions and Answers. CDC. Available at https://www.cdc.gov/coronavirus/2019-ncov/faq.html. October 19, 2021; Accessed: December 1, 2021.
FDA. Coronavirus (COVID-19) Update: Daily Roundup. fda.gov. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-daily-roundup. March 23, 2020; Accessed: December 1, 2021.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 Mar 13. [QxMD MEDLINE Link].
Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020 Feb 24. [QxMD MEDLINE Link].
Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol. 2020 Mar 3. 1-6. [QxMD MEDLINE Link].
Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology. 2020 Mar 10. 200823. [QxMD MEDLINE Link].
ACR. ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection. American College of Radiology. Available at https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection. March 22, 2020; Accessed: December 1, 2021.
Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020 Mar 4. [QxMD MEDLINE Link].
Wang Y, Liu Y, Liu L, Wang X, Luo N, Ling L. Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China. J Infect Dis. 2020 Mar 17. [QxMD MEDLINE Link].
Li M, Lei P, Zeng B, Li Z, Yu P, Fan B, et al. Coronavirus Disease (COVID-19): Spectrum of CT Findings and Temporal Progression of the Disease. Acad Radiol. 2020 Mar 20. [QxMD MEDLINE Link].
Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. Radiology. 2019 Mar 27. 201160. [QxMD MEDLINE Link].
Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MUG, Khan K. Pneumonia of Unknown Etiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel. J Travel Med. 2020 Jan 14. [QxMD MEDLINE Link].
WHO. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. WHO. Available at https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19. April 19, 2020; Accessed: December 1, 2021.
Gordon DE, Jang GM, Bouhaddou M, Xu J, Obernier K, O’Mera MJ, et al. A SARS-CoV-2-Human Protein-Protein Interaction Map Reveals Drug Targets and Potential Drug-Repurposing. bioRxiv. Available at https://www.biorxiv.org/content/10.1101/2020.03.22.002386v1. 2020 Mar 22; Accessed: December 1, 2021.
Arshad U, Pertinez H, Box H, Tatham L, Rajoki RKR, Curley P, et al. Prioritisation of potential anti-SARS-CoV-2 drug repurposing opportunities based on ability to achieve adequate target site concentrations derived from their established human pharmacokinetics. medRxiv. 2020 Apr 22. [Full Text].
World Health Organization. “Solidarity” clinical trial for COVID-19 treatments. WHO. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments. 2020 Oct 16; Accessed: December 1, 2021.
WHO Solidarity Trial Consortium. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results. N Engl J Med. 2020 Dec 2. [QxMD MEDLINE Link]. [Full Text].
Kalil AC. Treating COVID-19-Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics. JAMA. 2020 Mar 24. [QxMD MEDLINE Link]. [Full Text].
Rome BN, Avorn J. Drug Evaluation during the Covid-19 Pandemic. N Engl J Med. 2020 Apr 14. [QxMD MEDLINE Link]. [Full Text].
Frellick M. Key Drugs Join PPEs on List of Front-Line Shortages. Medscape Medical News. 2020 Apr 02. Available at https://www.medscape.com/viewarticle/928039.
Live Updates: Which Drugs Are In Shortage Because of COVID-19?. GoodRx. Available at https://www.goodrx.com/blog/covid-19-drug-shortages-updates/. July 13, 2020; Accessed: December 1, 2021.
Wilson FP. Hydroxychloroquine for COVID-19: What’s the Evidence? (Commentary). Medscape Medical News and Perspectives. 2020 Mar 25. Available at https://www.medscape.com/viewarticle/927342.
CDC. Coronavirus Disease 2019 (COVID-19): Community-Related Exposures. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html. March 1, 2021 (updated); Accessed: December 1, 2021.
CDC. Coronavirus Disease 2019 (COVID-19): Travel-Associated Exposures. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html. November 5, 2021 (updated); Accessed: December 1, 2021.
Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med. 2020. [Full Text].
Smith JD, MacDougall CC, Johnstone J, Copes RA, Schwartz B, Garber GE. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ. 2016 May 17. 188 (8):567-574. [QxMD MEDLINE Link].
TLR 2/6/9 agonist PUL-042. NCI Drug Dictionary. Available at https://www.cancer.gov/publications/dictionaries/cancer-drug/def/tlr-2-6-9-agonist-pul-042. Accessed: December 1, 2021.
The Use PUL-042 Inhalation Solution to Prevent COVID-19 in Adults Exposed to SARS-CoV-2. ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04313023. 2020 Mar 24; Accessed: December 1, 2021.
The Use of PUL-042 Inhalation Solution to Reduce the Severity of COVID-19 in Adults Positive for SARS-CoV-2 Infection. ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04312997?term=PUL-042&cond=COVID&cntry=US&draw=2&rank=2. 2020 May 07; Accessed: December 1, 2021.
FDA. Coronavirus (COVID-19) Update: FDA Issues Emergency Use Authorization for Potential COVID-19 Treatment. fda.gov. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment. May 01, 2020; Accessed: December 1, 2021.
COVID-19 Update: FDA Broadens Emergency Use Authorization for Veklury (remdesivir) to Include All Hospitalized Patients for Treatment of COVID-19. US Food and Drug Administration. 2020 Aug 28. Available at https://www.fda.gov/news-events/press-announcements/covid-19-update-fda-broadens-emergency-use-authorization-veklury-remdesivir-include-all-hospitalized?utm_campaign=FDA%20Broadens%20Emergency%20Use%20Authorization%20for%20Veklury%20%28Remdesivir%29%20to%.
Study in participants with early stage coronavirus disease 2019 (COVID-19) to evaluate the safety, efficacy, and pharmacokinetics of remdesivir administered by inhalation. ClinicalTrials.gov. Available at https://www.clinicaltrials.gov/ct2/show/NCT04539262. 2020 Dec 09; Accessed: December 1, 2021.
Holshue ML, DeBolt C, Lindquist S, and, the Washington State 2019-nCoV Case Investigation Team. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020 Mar 5. 382 (10):929-936. [QxMD MEDLINE Link].
National Institutes of Health. NIH clinical trial of remdesivir to treat COVID-19 begins. U.S. Department of Health and Human Services. Available at https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins. 2020 Feb 25; Accessed: March 24, 2020.
Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020 Oct 8. [QxMD MEDLINE Link]. [Full Text].
Harrington DP, Baden LR, Hogan JW. A Large, Simple Trial Leading to Complex Questions. N Engl J Med. 2020 Dec 2. [QxMD MEDLINE Link]. [Full Text].
Ader F, Bouscambert-Duchamp M, Hites M, and the, DisCoVeRy Study Group. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. Lancet Infect Dis. 2021 Sep 14. [QxMD MEDLINE Link]. [Full Text].
Goldman JD, Lye DCB, Hui DS, Marks KM, Bruno R, Montejano R, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19. N Engl J Med. November 5, 2020. 383:1827-1837. [QxMD MEDLINE Link]. [Full Text].
Spinner CD, Gottlieb RL, Criner GJ, and the, GS-US-540-5774 Investigators. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA. 2020 Aug 21. [QxMD MEDLINE Link]. [Full Text].
Gottlieb RL, Vaca CE, Paredes R, and the, GS-US-540-9012 (PINETREE) Investigators. Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients. N Engl J Med. 2021 Dec 22. [QxMD MEDLINE Link]. [Full Text].
Veklury (remdesivir) reduced risk of mortality in hospitalized COVID-19 patients across all variant time periods in a real world study of more than 500,000 patients. Gilead. 2023 Jan 21. Available at https://www.gilead.com/news-and-press/press-room/press-releases/2023/2/veklury-remdesivir-reduced-risk-of-mortality-in-hospitalized-covid19-patients-across-all-variant-time-periods-in-a-real-world-study-of-more-than-5.
Amstutz A, et al. Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomized controlled trials. Lancet Respir Med. 2023 Feb 21. [Full Text].
Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of Remdesivir (GS-5734) in Participants From Birth to < 18 Years of Age With Coronavirus Disease 2019 (COVID-19) (CARAVAN). ClinicalTrials.gov. Available at https://www.clinicaltrials.gov/ct2/show/NCT04431453. 2020 Jun 01; Accessed: December 1, 2021.
Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG, et al. Multicenter interim guidance on use of antivirals for children with COVID-19/SARS-CoV-2. J Pediatric Infect Dis Soc. 2020 Sep 12. [QxMD MEDLINE Link]. [Full Text].
Burwick RM, Yawetz S, Stephenson KE, Collier AY, Sen P, Blackburn BG, et al. Compassionate Use of Remdesivir in Pregnant Women with Severe Covid-19. Clin Infect Dis. 2020 Oct 8. [QxMD MEDLINE Link]. [Full Text].
McCoy JA, Short WR, Srinivas SK, Levine LD, Hirshberg A. Compassionate use of remdesivir for treatment of severe coronavirus disease 2019 in pregnant women at a United States academic center. Am J Obstet Gynecol MFM. 2020 Aug. 2 (3):100164. [QxMD MEDLINE Link]. [Full Text].
Wong CKH, Lau KTK, Au ICH, Lau EHY, Poon LLM, Hung IFN, et al. Viral burden rebound in hospitalised patients with COVID-19 receiving oral antivirals in Hong Kong: a population-wide retrospective cohort study. Lancet Infect Dis. 2023 Feb 13. [QxMD MEDLINE Link]. [Full Text].
Zheng Q, Ma P, Wang M, Cheng Y, Zhou M, Ye L, et al. Efficacy and safety of Paxlovid for COVID-19:a meta-analysis. J Infect. 2023 Jan. 86 (1):66-117. [QxMD MEDLINE Link]. [Full Text].
Hammond J, Leister-Tebbe H, Gardner A, and the, EPIC-HR Investigators. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022 Feb 16. [QxMD MEDLINE Link]. [Full Text].
Pfizer announces additional phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk of hospitalization or death. Pfizer, Inc. 2021 Dec 14. Available at https://www.pfizer.com/news/press-release/press-release-detail/pfizer-announces-additional-phase-23-study-results.
A post-exposure prophylaxis study of PF-07321332/ritonavir in adult household contacts of an individual with symptomatic COVID-19. ClinicalTrials.gov. Available at https://www.clinicaltrials.gov/ct2/show/NCT05047601. 2021 Dec 01; Accessed: December 14, 2021.
Xie Y, Choi T, Al-Aly Z. Nirmatrelvir and the risk of post-acute sequelae of COVID-19. medRxiv. November 5, 2022. [Full Text].
Liu J, Pan X, Zhang S, Li M, Ma K, Fan C, et al. Efficacy and safety of Paxlovid in severe adult patients with SARS-Cov-2 infection: a multicenter randomized controlled study. Lancet Reg Health West Pac. 2023 Feb 6. 100694. [QxMD MEDLINE Link]. [Full Text].
Jayk Bernal A, Gomes da Silva MM, Musungaie DB, and the, MOVe-OUT Study Group. Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients. N Engl J Med. 2022 Feb 10. 386:509-520. [QxMD MEDLINE Link]. [Full Text].
Xie Y, Bowe B, Al-Aly Z. Molnupiravir and risk of hospital admission or death in adults with covid-19: emulation of a randomized target trial using electronic health records. BMJ. 2023 Mar 7. 380:e072705. [QxMD MEDLINE Link]. [Full Text].
Najjar-Debbiny R, Gronich N, Weber G, Khoury J, Amar M, Stein N, et al. Effectiveness of Molnupiravir in High-Risk Patients: A Propensity Score Matched Analysis. Clin Infect Dis. 2023 Feb 8. 76 (3):453-460. [QxMD MEDLINE Link]. [Full Text].
Merck provides update on phase 3 MOVe-AHEAD trial evaluating Lagevrio (molnupiravir) for post-exposure prophylaxis for prevention of COVID-19. Merck. 2023 Feb 21. Available at https://www.merck.com/news/merck-provides-update-on-phase-3-move-ahead-trial-evaluating-lagevrio-molnupiravir-for-post-exposure-prophylaxis-for-prevention-of-covid-19/.
Study Evaluating GS-5245 in nonhospitalized participants with COVID-19. ClinicalTrials.gov. Available at https://www.clinicaltrials.gov/ct2/show/NCT05715528. 2023 Apr 03; Accessed: April 6, 2023.
Yotsuyanagi H, Ohmagari N, Doi Y, Imamura T, Sonoyama T, Ichihashi G, et al. A phase 2/3 study of S-217622 in participants with SARS-CoV-2 infection (Phase 3 part). Medicine (Baltimore). 2023 Feb 22. 102 (8):e33024. [QxMD MEDLINE Link]. [Full Text].
Bucillamine in treatment of patients with COVID-19. ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04504734. 2022 Oct 27; Accessed: January 27, 2023.
Yao Z, Geng B, Marcon E, Pu S, Tang H, Merluza J, et al. Omicron spike protein is vulnerable to reduction. bioRxiv. 2023 Jan 06. [Full Text].
Cao Z, Gao W, Bao H, Feng H, Mei S, Chen P, et al. VV116 versus Nirmatrelvir-Ritonavir for Oral Treatment of Covid-19. N Engl J Med. 2022 Dec 28. [QxMD MEDLINE Link]. [Full Text].
A study of opaganib in coronavirus disease 2019 pneumonia (COVID-19). ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04414618. 2022 Mar 21; Accessed: April 13, 2022.
Smith CD, Maines LW, Keller SN, Katz Ben-Yair V, Fathi R, Plasse TF, et al. Recent Progress in the Development of Opaganib for the Treatment of Covid-19. Drug Des Devel Ther. 2022. 16:2199-2211. [QxMD MEDLINE Link]. [Full Text].
Sabizabulin (VERU-111) for COVID-19. Veru, Inc. Available at https://verupharma.com/pipeline/sabizabulin-for-covid-19/. 2022; Accessed: 2022 Apr 13.
Barnette KG, Gordon MS, Rodriquez D, and the, Phase 3 COVID-19 Investigators. Oral sabizabulin for high-risk, hospitalized adults with COVID-19: Interim Analysis. NEJM Evid. 2022 Jul. 1(9):[Full Text].
Atea Pharmaceuticals provides clinical and corporate update and reports second quarter 2021 financial results. Atea Pharmaceuticals. Available at https://ir.ateapharma.com/news-releases/news-release-details/atea-pharmaceuticals-provides-clinical-and-corporate-update-and. 2021 Aug 12; Accessed: December 1, 2021.
Atea to Advance Global Phase 3 Registrational Study of Bemnifosbuvir in High-Risk Non-Hospitalized Patients with COVID-19. Atea Pharmaceuticals. 2022 Sep 13. Available at https://ir.ateapharma.com/news-releases/news-release-details/atea-advance-global-phase-3-registrational-study-bemnifosbuvir.
Martins-Filho PR, do Nascimento-Júnior EM, Barreto-Alves JA, Fakhouri R, Ferreira LC. Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. Eur J Clin Pharmacol. 2022 Sep 6. [QxMD MEDLINE Link]. [Full Text].
Niclosamide in moderate COVID-19. ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04436458. 2020 Jun 18; Accessed: December 1, 2021.
ANA Therapeutics begins phase 2/3 clinical trial of proprietary oral niclosamide formulation to treat COVID-19. Businesswire. Available at https://www.businesswire.com/news/home/20201026005569/en/ANA-Therapeutics-Begins-Phase-23-Clinical-Trial-of-Proprietary-Oral-Niclosamide-Formulation-to-Treat-COVID-19. 2020 Oct 26; Accessed: December 1, 2021.
Ingraham NE, Lotfi-Emran S, Thielen BK, Techar K, Morris RS, Holtan SG, et al. Immunomodulation in COVID-19. Lancet Respir Med. 2020 May 4. [QxMD MEDLINE Link]. [Full Text].
Rizk JG, Kalantar-Zadeh K, Mehra MR, Lavie CJ, Rizk Y, Forthal DN. Pharmaco-Immunomodulatory Therapy in COVID-19. Drugs. 2020 Sep. 80 (13):1267-1292. [QxMD MEDLINE Link]. [Full Text].
Peterson JH, Paranjape NS, Grundlingh N, Priestley JL. Outcomes and Adverse Effects of Baricitinib Versus Tocilizumab in the Management of Severe COVID-19. Crit Care Med. 2023 Mar 1. 51 (3):337-346. [QxMD MEDLINE Link]. [Full Text].
Cawcutt KA, Kalil AC. Baricitinib or Tocilizumab? Treatment of Patients Hospitalized With Severe COVID-19. Crit Care Med. 2023 Mar 1. 51 (3):413-415. [QxMD MEDLINE Link].
Stebbing J, Phelan A, Griffin I, Tucker C, Oechsle O, Smith D, et al. COVID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis. 2020 Apr. 20 (4):400-402. [QxMD MEDLINE Link]. [Full Text].
Richardson P, Griffin I, Tucker C, Smith D, Oechsle O, Phelan A, et al. Baricitinib as potential treatment for 2019-nCoV acute respiratory disease. Lancet. 2020 Feb 15. 395 (10223):e30-e31. [QxMD MEDLINE Link]. [Full Text].
Stebbing J, Krishnan V, de Bono S, Ottaviani S, Casalini G, Richarson PJ, et al. Mechanism of baricitinib supports artificial intelligence-predicted testing in COVID-19 patients. 2020 Apr 15. [Full Text].
Kalil AC, Patterson TF, Mehta AK, Tomashek KM, Wolfe CR, Ghazaryan V, et al. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19. N Engl J Med. 2020 Dec 11. [QxMD MEDLINE Link]. [Full Text].
Kalil AC, Stebbing J. Baricitinib: the first immunomodulatory treatment to reduce COVID-19 mortality in a placebo-controlled trial. Lancet Respir Med. 2021 Aug 31. [QxMD MEDLINE Link]. [Full Text].
Marconi VC, Ramanan AV, de Bono S, Kartman CE, Krishnan V, Liao R, et al. Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial. Lancet Respir Med. 2021 Aug 31. [QxMD MEDLINE Link]. [Full Text].
Lilly and Incyte’s baricitinib reduced deaths among patients with COVID-19 receiving invasive mechanical ventilation. Lilly. Available at https://investor.lilly.com/news-releases/news-release-details/lilly-and-incytes-baricitinib-reduced-deaths-among-patients. 2021 Aug 03; Accessed: December 1, 2021.
Guimarães PO, Quirk D, Furtado RH, and the STOP-COVID Trial Investigators. Tofacitinib in patients hospitalized with COVID-19 pneumonia. N Engl J Med. 2021 Jun 16. [QxMD MEDLINE Link]. [Full Text].
Wagner JL, Veve MP, Barber KE. Using IL-6 inhibitors to treat COVID-19. ContagionLive. Available at https://www.contagionlive.com/publications/contagion/2020/august/using-il6-inhibitors-to-treat-covid19?ekey=c2NiZXJnbWFuQG5lYnJhc2thbWVkLmNvbQ. 2020 Aug 17; Accessed: December 1, 2021.
[Guideline] NIH. The COVID-19 Treatment Guidelines Panel’s Statement on the Use of Tocilizumab (and Other Interleukin-6 Inhibitors) for the Treatment of COVID-19. COVID-19 Treatment Guidelines. Available at https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/interleukin-6-inhibitors/. 2021 Mar 05; Accessed: December 1, 2021.
Salama C, Han J, Yau L, Reiss WG, Kramer B, Neidhart JD, et al. Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia. N Engl J Med. 2021 Jan 7. 384 (1):20-30. [QxMD MEDLINE Link]. [Full Text].
Rosas IO, Diaz G, Gottlieb RL, Lobo SM, Robinson P, Hunter BD, et al. Tocilizumab and remdesivir in hospitalized patients with severe COVID-19 pneumonia: a randomized clinical trial. Intensive Care Med. 2021 Nov. 47 (11):1258-1270. [QxMD MEDLINE Link]. [Full Text].
REMAP-CAP Investigators., Gordon AC, Mouncey PR, Al-Beidh F, et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med. 2021 Apr 22. 384 (16):1491-1502. [QxMD MEDLINE Link]. [Full Text].
RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 May 1. 397 (10285):1637-1645. [QxMD MEDLINE Link]. [Full Text].
Rosas IO, Bräu N, Waters M, Go RC, Hunter BD, Bhagani S, et al. Tocilizumab in Hospitalized Patients with Severe Covid-19 Pneumonia. N Engl J Med. 2021 Apr 22. 384 (16):1503-1516. [QxMD MEDLINE Link]. [Full Text].
Rubin EJ, Longo DL, Baden LR. Interleukin-6 Receptor Inhibition in Covid-19 - Cooling the Inflammatory Soup. N Engl J Med. 2021 Apr 22. 384 (16):1564-1565. [QxMD MEDLINE Link]. [Full Text].
[Guideline] NIH. Interleukin-1 Inhibitors. COVID-19 Treatment Guidelines. Available at https://www.covid19treatmentguidelines.nih.gov/immune-based-therapy/interleukin-1-inhibitors/. 2020 Jul 17; Accessed: September 8, 2021.
Intereukin-7 to improve clinical outcomes in lymphopenic patients with COVID-19 infection FR BL Cohort (ILIAD-7-FR). ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04407689. 2020 Jun 22; Accessed: December 1, 2021.
Interleukin-7 (CYT107 to improve clinical outcomes in lymphopenic patients with COVID-19 infection UK cohort (ILIAD-7-UK). ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04379076. 2020 May 15; Accessed: December 1, 2021.
Laterre PF, François B, Collienne C, Hantson P, Jeannet R, Remy KE, et al. Association of Interleukin 7 Immunotherapy With Lymphocyte Counts Among Patients With Severe Coronavirus Disease 2019 (COVID-19). JAMA Netw Open. 2020 Jul 1. 3 (7):e2016485. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. World Health Organization. Available at https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected. 2020 Mar 13; Accessed: March 24, 2020.
Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020 Feb 15. 395 (10223):473-475. [QxMD MEDLINE Link].
[Guideline] Alhazzani W, Evans L, Alshamsi F, Møller MH, Ostermann M, Prescott HC, et al. Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update. Crit Care Med. 2021 Mar 1. 49 (3):e219-e234. [QxMD MEDLINE Link]. [Full Text].
WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19: A Meta-analysis. JAMA. 2020 Sep 2. [QxMD MEDLINE Link]. [Full Text].
Prescott HC, Rice TW. Corticosteroids in COVID-19 ARDS: Evidence and Hope During the Pandemic. JAMA. 2020 Sep 2. [QxMD MEDLINE Link]. [Full Text].
[Guideline] WHO. Corticosteroids for COVID-19 – Living Guidance. World Health Organization. Available at https://www.who.int/publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1. 2020 Sep 02; Accessed: December 1, 2021.
Afzali B, Noris M, Lambrecht BN, Kemper C. The state of complement in COVID-19. Nat Rev Immunol. 2022 Feb. 22 (2):77-84. [QxMD MEDLINE Link]. [Full Text].
Carvelli J, Demaria O, Vély F, Batista L, Chouaki Benmansour N, Fares J, et al. Association of COVID-19 inflammation with activation of the C5a-C5aR1 axis. Nature. 2020 Dec. 588 (7836):146-150. [QxMD MEDLINE Link]. [Full Text].
Aiello S, Gastoldi S, Galbusera M, Ruggenenti P, Portalupi V, Rota S, et al. C5a and C5aR1 are key drivers of microvascular platelet aggregation in clinical entities spanning from aHUS to COVID-19. Blood Adv. 2022 Jan 8. 6 (3):866-881. [QxMD MEDLINE Link]. [Full Text].
Vlaar APJ, Witzenrath M, van Paassen P, and the, PANAMO study group. Anti-C5a antibody (vilobelimab) therapy for critically ill, invasively mechanically ventilated patients with COVID-19 (PANAMO): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Respir Med. 2022 Dec. 10 (12):1137-1146. [QxMD MEDLINE Link]. [Full Text].
NRx Pharmaceuticals identifies significantly higher likelihood of surviving and recovering from critical COVID-19 in Zyesami (aviptadil) treated patients previously administered remdesivir. NeuroRx Pharmaceuticals. 2021 November 29. Available at https://www.nrxpharma.com/nrx-pharmaceuticals-identifies-significantly-higher-likelihood-of-surviving-and-recovering-from-critical-covid-19-in-zyesami-aviptadil-treated-patients-previously-administered-remdesivir/.
Inhaled aviptadil for the treatment of moderate and severe COVID-19 (AVICOVID-2). ClinicalTrials.gov. Available at https://clinicaltrials.gov/ct2/show/NCT04360096. 2021 Mar 11; Accessed: December 1, 2021.
Strich JR, Tian X, Samour M, King CS, Shlobin O, Reger R, et al. Fostamatinib for the treatment of hospitalized adults with COVD-19 A randomized trial. Clin Infect Dis. 2021 Sep 1. [QxMD MEDLINE Link]. [Full Text].
Reis G, Moreira Silva EAS, Medeiros Silva DC, and the, TOGETHER Investigators. Early Treatment with Pegylated Interferon Lambda for Covid-19. N Engl J Med. 2023 Feb 9. 388 (6):518-528. [QxMD MEDLINE Link]. [Full Text].
Kalil AC, Mehta AK, Patterson TF, and the, ACTT-3 study group members. Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial. Lancet Respir Med. 2021 Oct 18. [QxMD MEDLINE Link]. [Full Text].
Schönbeck U, Libby P. Inflammation, immunity, and HMG-CoA reductase inhibitors: statins as antiinflammatory agents?. Circulation. 2004 Jun 1. 109 (21 Suppl 1):II18-26. [QxMD MEDLINE Link]. [Full Text].
Hariyanto TI, Kurniawan A. Statin therapy did not improved the in-hospital outcome of coronavirus disease 2019 (COVID-19) infection. Diabetes Metab Syndr. 2020 Aug 26. 14(6):1613-1615. [QxMD MEDLINE Link]. [Full Text].
Kow CS, Hasan SS. Meta-analysis of Effect of Statins in Patients with COVID-19. Am J Cardiol. 2020 Aug 12. [QxMD MEDLINE Link]. [Full Text].
Castiglione V, Chiriacò M, Emdin M, Taddei S, Vergaro G. Statin therapy in COVID-19 infection. Eur Heart J Cardiovasc Pharmacother. 2020 Jul 1. 6 (4):258-259. [QxMD MEDLINE Link]. [Full Text].
[Guideline] NIH. Covid-19 Treatment Guidelines - Adjunctive Therapy. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/adjunctive-therapy/. 2020 Jul 17; Accessed: December 1, 2021.
Yao JS, Paguio JA, Dee EC, Tan HC, Moulick A, Milazzo C, et al. The minimal effect of zinc on the survival of hospitalized patients with Covid-19: an observational study. Chest. 2020 Jul 22. [QxMD MEDLINE Link]. [Full Text].
Meltzer DO, Best TJ, Zhang H, Vokes T, Arora V, Solway J. Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. JAMA Netw Open. 2020 Sep 1. 3 (9):e2019722. [QxMD MEDLINE Link]. [Full Text].
Sahota O. Understanding vitamin D deficiency. Age Ageing. 2014 Sep. 43 (5):589-91. [QxMD MEDLINE Link]. [Full Text].
Bishop CW, Ashfaq A, Melnick JZ, Vazquez-Escarpanter E, Fialkow JA, Strugnell SA, et al. Results from the REsCUe trial: a randomized controlled trial with extended-release calcifediol in symptomatic outpatients with COVID-19. medRXiv. 2022 Feb 05. [Full Text].
NIH COVID-19 Treatment Guidelines Panel. Statement on the emergency use authorization of convalescent plasma for the treatment of COVID-19. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/statement-on-convalescent-plasma-eua/. 2022 Dec 01; Accessed: February 1, 2023.
Senefeld JW, Franchini M, Mengoli C, Cruciani M, Zani M, Gorman EK, et al. COVID-19 Convalescent Plasma for the Treatment of Immunocompromised Patients: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023 Jan 3. 6 (1):e2250647. [QxMD MEDLINE Link]. [Full Text].
Writing Committee for the REMAP-CAP Investigators, Estcourt LJ, Turgeon AF, McQuilten ZK, et al. Effect of Convalescent Plasma on Organ Support-Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2021 Oct 4. [QxMD MEDLINE Link].
Levin MJ, Ustianowski A, De Wit S, and the, PROVENT Study Group. Intramuscular AZD7442 (Tixagevimab-Cilgavimab) for Prevention of Covid-19. N Engl J Med. 2022 Jun 9. 386 (23):2188-2200. [QxMD MEDLINE Link]. [Full Text].
Young-Xu Y, Epstein L, Marconi VC, Davey V, Zwain G, Smith J, et al. Tixagevimab/cilagavimab for prevention of COVID-19 during the omicron surge: Retrospective analysis of national VA electronic data. medRxiv. 2022 May 29. [Full Text].
Westendorf K, Žentelis S, Wang L, Foster D, Vaillancourt P, Wiggin M, et al. LY-CoV1404 (bebtelovimab) potently neutralizes SARS-CoV-2 variants. Cell Rep. 2022 May 17. 39 (7):110812. [QxMD MEDLINE Link]. [Full Text].
Gupta A, Gonzalez-Rojas Y, Juarez E, and the, COMET-ICE Investigators. Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab. N Engl J Med. 2021 Nov 18. 385 (21):1941-1950. [QxMD MEDLINE Link]. [Full Text].
GSK and Vir submit emergency use authorization application to FDA for intramuscular administration of sotrovimab for the early treatment of COVID-19. GlaxoSmithKline. 2022 Jan 13. Available at https://us.gsk.com/en-us/media/press-releases/gsk-and-vir-submit-emergency-use-authorization-application-to-fda-for-intramuscular-administration-of-sotrovimab-for-the-early-treatment-of-covid-19/.
O'Brien MP, Forleo-Neto E, Musser BJ, and the, Covid-19 Phase 3 Prevention Trial Team. Subcutaneous REGEN-COV Antibody Combination to Prevent Covid-19. N Engl J Med. 2021 Aug 4. [QxMD MEDLINE Link]. [Full Text].
Weinreich DM, Sivapalasingam S, Norton T, Ali S, Gao H, Bhore R, et al. REGN-COV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19. N Engl J Med. 2020 Dec 17. [QxMD MEDLINE Link]. [Full Text].
RECOVERY Collaborative Group, Horby PW, Mafham M, Peto L, et al. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomized, controlled, open-label, platform trial. medRxiv. 2021 Jun 16. [Full Text].
Dougan M, Nirula A, Azizad M, and the, BLAZE-1 Investigators. Bamlanivimab plus Etesevimab in Mild or Moderate Covid-19. N Engl J Med. 2021 Oct 7. 385 (15):1382-1392. [QxMD MEDLINE Link]. [Full Text].
Cohen MS, Nirula A, Mulligan MJ, and the, BLAZE-2 Investigators. Effect of Bamlanivimab vs Placebo on Incidence of COVID-19 Among Residents and Staff of Skilled Nursing and Assisted Living Facilities: A Randomized Clinical Trial. JAMA. 2021 Jul 6. 326 (1):46-55. [QxMD MEDLINE Link]. [Full Text].
Lurie N, Saville M, Hatchett R, Halton J. Developing Covid-19 Vaccines at Pandemic Speed. N Engl J Med. 2020 May 21. 382 (21):1969-1973. [QxMD MEDLINE Link]. [Full Text].
Koirala A, Joo YJ, Khatami A, Chiu C, Britton PN. Vaccines for COVID-19: The current state of play. Paediatr Respir Rev. 2020 Sep. 35:43-49. [QxMD MEDLINE Link]. [Full Text].
Iba T, Levy JH, Levi M, Connors JM, Thachil J. Coagulopathy of Coronavirus Disease 2019. Crit Care Med. 2020 Sep. 48 (9):1358-1364. [QxMD MEDLINE Link]. [Full Text].
Katneni UK, Alexaki A, Hunt RC, Schiller T, DiCuccio M, Buehler PW, et al. Coagulopathy and Thrombosis as a Result of Severe COVID-19 Infection: A Microvascular Focus. Thromb Haemost. 2020 Aug 24. [QxMD MEDLINE Link]. [Full Text].
Ferguson J, Volk S, Vondracek T, Flanigan J, Chernaik A. Empiric therapeutic anticoagulation and mortality in critically ill patients with respiratory failure from SARS-CoV-2: A retrospective cohort study. J Clin Pharmacol. 2020 Sep 3. [QxMD MEDLINE Link]. [Full Text].
Paranjpe I, Fuster V, Lala A, Russak AJ, Glicksberg BS, Levin MA, et al. Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19. J Am Coll Cardiol. 2020 Jul 7. 76 (1):122-124. [QxMD MEDLINE Link]. [Full Text].
NIH ACTIV-4B COVID-19 outpatient thrombosis prevention trial ends early. Brigham Health. 2021 Jun 22. Available at https://www.brighamandwomens.org/about-bwh/newsroom/press-releases-detail?id=3925.
REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators, Goligher EC, Bradbury CA, McVerry BJ, et al. Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19. N Engl J Med. 2021 Aug 4. [QxMD MEDLINE Link]. [Full Text].
ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators, Lawler PR, Goligher EC, Berger JS, et al. Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19. N Engl J Med. 2021 Aug 4. [QxMD MEDLINE Link]. [Full Text].
Assessing Safety, Hospitalization and Efficacy of rNAPc2 in COVID-19 (ASPEN). ClinicalTrials.gov. Available at https://www.clinicaltrials.gov/ct2/show/NCT04655586. 2021 Nov 03; Accessed: December 6, 2021.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar. 579 (7798):270-273. [QxMD MEDLINE Link]. [Full Text].
Lopes RD, Macedo AVS, de Barros E Silva PGM, Moll-Bernardes RJ, Feldman A, D'Andréa Saba Arruda G, et al. Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--The BRACE CORONA Trial. Am Heart J. 2020 Aug. 226:49-59. [QxMD MEDLINE Link]. [Full Text].
Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. Coronavirus Disease 2019 (COVID-19) and Cardiovascular Disease. Circulation. 2020 Mar 21. [QxMD MEDLINE Link]. [Full Text].
Fang L, Karakiulakis G, Roth M. Correction to Lancet Respir Med 2020; 8: e21. Lancet Respir Med. 2020 Jun. 8 (6):e54. [QxMD MEDLINE Link]. [Full Text].
Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005 Aug. 11 (8):875-9. [QxMD MEDLINE Link]. [Full Text].
Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon S. Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19. N Engl J Med. 2020 March 30. [QxMD MEDLINE Link]. [Full Text].
Ishiyama Y, Gallagher PE, Averill DB, Tallant EA, Brosnihan KB, Ferrario CM. Upregulation of angiotensin-converting enzyme 2 after myocardial infarction by blockade of angiotensin II receptors. Hypertension. 2004 May. 43 (5):970-6. [QxMD MEDLINE Link]. [Full Text].
Ferrario CM, Jessup J, Chappell MC, Averill DB, Brosnihan KB, Tallant EA, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005 May 24. 111 (20):2605-10. [QxMD MEDLINE Link]. [Full Text].
Klimas J, Olvedy M, Ochodnicka-Mackovicova K, Kruzliak P, Cacanyiova S, Kristek F, et al. Perinatally administered losartan augments renal ACE2 expression but not cardiac or renal Mas receptor in spontaneously hypertensive rats. J Cell Mol Med. 2015 Aug. 19 (8):1965-74. [QxMD MEDLINE Link]. [Full Text].
Walters TE, Kalman JM, Patel SK, Mearns M, Velkoska E, Burrell LM. Angiotensin converting enzyme 2 activity and human atrial fibrillation: increased plasma angiotensin converting enzyme 2 activity is associated with atrial fibrillation and more advanced left atrial structural remodelling. Europace. 2017 Aug 1. 19 (8):1280-1287. [QxMD MEDLINE Link]. [Full Text].
Burchill LJ, Velkoska E, Dean RG, Griggs K, Patel SK, Burrell LM. Combination renin-angiotensin system blockade and angiotensin-converting enzyme 2 in experimental myocardial infarction: implications for future therapeutic directions. Clin Sci (Lond). 2012 Dec. 123 (11):649-58. [QxMD MEDLINE Link].
Bozkurt B, Kovacs R, Harrington B. Joint HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. J Card Fail. 2020 May. 26 (5):370. [QxMD MEDLINE Link]. [Full Text].
Sama IE, Ravera A, Santema BT, van Goor H, Ter Maaten JM, Cleland JGF, et al. Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. Eur Heart J. 2020 May 14. 41 (19):1810-1817. [QxMD MEDLINE Link]. [Full Text].
Baral R, Tsampasian V, Debski M, Moran B, Garg P, Clark A, et al. Association Between Renin-Angiotensin-Aldosterone System Inhibitors and Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 Mar 1. 4 (3):e213594. [QxMD MEDLINE Link]. [Full Text].
Torres A, Blasi F, Dartois N, Akova M. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax. 2015 Oct. 70 (10):984-9. [QxMD MEDLINE Link]. [Full Text].
Drucker DJ. Coronavirus infections and type 2 diabetes-shared pathways with therapeutic implications. Endocr Rev. 2020 Apr 15. [QxMD MEDLINE Link]. [Full Text].
Muniyappa R, Gubbi S. COVID-19 Pandemic, Corona Viruses, and Diabetes Mellitus. Am J Physiol Endocrinol Metab. 2020 Mar 31. [QxMD MEDLINE Link]. [Full Text].
DPP4 dipeptidyl peptidase 4. National Center for Biotechnology Information (NCBI). Available at https://www.ncbi.nlm.nih.gov/gene/1803. 2020 Apr 20; Accessed: 2020 Apr 21.
RECOVERY Collaborative Group. Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomized, controlled, open-label, platform trial. The Lancet. 2020 Oct 05. [Full Text].
Momekov G, Momekova D. Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view: antiviral levels are not likely attainable with known dosing regimens. Biotechnology & Biotechnological Equipment. 2020. 2020. 34(1):469-74. [Full Text].
Chaccour C, Hammann F, Ramón-García S, Rabinovich NR. Ivermectin and Novel Coronavirus Disease (COVID-19): Keeping Rigor in Times of Urgency. Am J Trop Med Hyg. 2020 Apr 16. [QxMD MEDLINE Link]. [Full Text].
López-Medina E, López P, Hurtado IC, Dávalos DM, Ramirez O, Martínez E, et al. Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial. JAMA. 2021 Apr 13. 325 (14):1426-1435. [QxMD MEDLINE Link]. [Full Text].
Lim SCL, Hor CP, Tay KH, and the, I-TECH Study Group. Efficacy of Ivermectin Treatment on Disease Progression Among Adults With Mild to Moderate COVID-19 and Comorbidities: The I-TECH Randomized Clinical Trial. JAMA Intern Med. 2022 Feb 18. [QxMD MEDLINE Link]. [Full Text].
Reis G, Silva EASM, Silva DCM, and the, TOGETHER Investigators. Effect of Early Treatment with Ivermectin among Patients with Covid-19. N Engl J Med. 2022 May 5. 386 (18):1721-1731. [QxMD MEDLINE Link]. [Full Text].
Naggie S, Boulware DR, Lindsell CJ, for the, Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV-6) Study Group and Investigators. Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial. JAMA. 2022 Oct 25. 328 (16):1595-1603. [QxMD MEDLINE Link]. [Full Text].
Naggie S, Boulware DR, Lindsell CJ, for the, Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV)-6 Study Group and Investigators. Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19: A Randomized Clinical Trial. JAMA. 2023 Feb 20. [QxMD MEDLINE Link]. [Full Text].
Bramante CT, Huling JD, Tignanelli CJ, for the COVID-OUT Trial Team. Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19. N Eng J Med. 2022. 387:599-610. [Full Text].
Reis G, Dos Santos Moreira-Silva EA, Silva DCM, and the, TOGETHER investigators. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health. 2022 Jan. 10 (1):e42-e51. [QxMD MEDLINE Link]. [Full Text].
McCarthy MW, Naggie S, Boulware DR, and the, Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-6 Study Group and Investigators. Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial. JAMA. 2023 Jan 24. 329 (4):296-305. [QxMD MEDLINE Link].
Golan Y, Campos JAS, Woolson R, Cilla D, Hanabergh R, Gonzales-Rojas Y, et al. Favipiravir in Patients With Early Mild-to-moderate Coronavirus Disease 2019 (COVID-19): A Randomized Controlled Trial. Clin Infect Dis. 2023 Feb 8. 76 (3):e10-e17. [QxMD MEDLINE Link]. [Full Text].
Ray WA, Murray KT, Hall K, Arbogast PG, Stein CM. Azithromycin and the risk of cardiovascular death. N Engl J Med. 2012 May 17. 366 (20):1881-90. [QxMD MEDLINE Link]. [Full Text].
Simpson TF, Kovacs RJ, Stecker EC. Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19. American College of Cardiology; Cardiology Magazine. Available at https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19. 2020 Mar 29; Accessed: April 1, 2020.
[Guideline] Roden DM, Harrington RA, Poppas A, Russo AM. Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 2019) Treatment. Circulation. 2020 Apr 8. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Giudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ. Urgent guidance for navigating and circumventing the QTc prolonging and torsadogenic potential of possible pharmacotherapies for COVID-19. Mayo Clin Proc. 2020 Apr 07. [Full Text].
Mercuro NJ, Yen CF, Shim DJ, Maher TR, McCoy CM, Zimetbaum PJ, et al. Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020 May 1. [QxMD MEDLINE Link]. [Full Text].
Chorin E, Dai M, Shulman E, Wadhwani L, et al. The QT Interval in Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine/Azithromycin. medRxiv. 2020 Apr 03. [Full Text].
Borba M, de Almeida Val F, Sampaio VS, Alexandre MA, Melo GC, Brito M, et al. Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study). MedRxiv. 2020 Apr 11. [Full Text].
Lane JCE, Weaver J, Kostka K, Duarte-Salles T, Abrahao MTF, Alghoul H, et al. Safety of hydroxychloroquine, alone and in combination with azithromycin, in light of rapid wide-spread use for COVID-19: a multinational, network cohort and self-controlled case series study. medRxiv. 2020 Apr 10. [Full Text].
FDA Combating COVID-19 with Medical Devices. US Food and Drug Administration. Available at https://www.fda.gov/media/136702/download. 2020 Jun 15; Accessed: June 19, 2020.
Zhang Q, et al. Cellular nanosponges inhibit SARS-CoV-2 infectivity. Nano Lett. 2020 Jun 17. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Centers for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens from persons for coronavirus disease 2019 (COVID-19). CDC. Available at https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html. 2020 Nov 05; Accessed: November 16, 2020.
[Guideline] Center for Clinical Standards and Quality/Quality, Safety & Oversight Group. Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge. Available at https://www.cms.gov/files/document/qso-20-13-hospitalspdf.pdf-2. March 4, 2020; Accessed: March 4, 2020.
Puopolo KM, Hudak ML, Kimberlin DW, Cummings J. Management of Infants Born to Mothers with COVID-19. American Academy of Pediatrics. Available at https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf. April 2, 2020; Accessed: April 3, 2020.
[Guideline] AAP. FAQs: Management of Infants Born to Mothers with Suspected or Confirmed COVID-19. American Academy of Pediatrics. Available at https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/faqs-management-of-infants-born-to-covid-19-mothers/. May 21, 2020; Accessed: May 27, 2020.
[Guideline] COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. 2021 Mar 05; Accessed: March 12, 2021.
[Guideline] Moores LK, Tritschler T, Brosnahan S, Carrier M, Collen JF, Doerschug K, et al. Prevention, diagnosis and treatment of venous thromboembolism in patients with COVID-19: CHEST Guideline and Expert Panel Report. Chest. 2020 Jun 2. [QxMD MEDLINE Link]. [Full Text].
[Guideline] Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020 May. 18 (5):1023-1026. [QxMD MEDLINE Link]. [Full Text].
[Guideline] COVID-19 Treatment Guidelines Panel. Antithrombotic Therapy in Patients with COVID-19. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/antithrombotic-therapy/. 2021 Feb 11; Accessed: June 28, 2021.
Lim EHT, Vlaar APJ, Bos LDJ, and the, Amsterdam UMC COVID-19 Biobank Investigators. Anti-C5a antibody vilobelimab treatment and the effect on biomarkers of inflammation and coagulation in patients with severe COVID-19: a substudy of the phase 2 PANAMO trial. Respir Res. 2022 Dec 24. 23 (1):375. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

The heart is normal in size. There are diffuse, patchy opacities throughout both lungs, which may represent multifocal viral/bacterial pneumonia versus pulmonary edema. These opacities are particularly confluent along the periphery of the right lung. There is left midlung platelike atelectasis. Obscuration of the left costophrenic angle may represent consolidation versus a pleural effusion with atelectasis. There is no pneumothorax.
The heart is normal in size. There are bilateral hazy opacities, with lower lobe predominance. These findings are consistent with multifocal/viral pneumonia. No pleural effusion or pneumothorax are seen.
The heart is normal in size. Patchy opacities are seen throughout the lung fields. Patchy areas of consolidation at the right lung base partially silhouettes the right diaphragm. There is no effusion or pneumothorax. Degenerative changes of the thoracic spine are noted.
The same patient as above 10 days later.
The trachea is in midline. The cardiomediastinal silhouette is normal in size. There are diffuse hazy reticulonodular opacities in both lungs. Differential diagnoses include viral pneumonia, multifocal bacterial pneumonia or ARDS. There is no pleural effusion or pneumothorax.
Axial chest CT demonstrates patchy ground-glass opacities with peripheral distribution.
Coronal reconstruction chest CT of the same patient above, showing patchy ground-glass opacities.
Axial chest CT shows bilateral patchy consolidations (arrows), some with peripheral ground-glass opacity. Findings are in peripheral and subpleural distribution.

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Table 1. SARS-CoV-2 Monoclonal Antibodies – inactive EUAs

Table 1. SARS-CoV-2 Monoclonal Antibodies – inactive EUAs

Antibody	Description
Evusheld (tixagevimab/cilgavimab)	EUA for preexposure prophylaxis halted in January 2023 owing to Omicron XBB VOCs. Initial authorization was based on the phase 3 PROVENT in unvaccinated individuals with comorbidities and a retrospective cohort study of veterans who were immunosuppressed.^{[253, 254]}
Bebtelovimab	Data supporting the treatment EUA were primarily based on analyses from the phase 2 BLAZE-4 trial conducted before the emergence of the Omicron BQ.1 and BQ.1.1 VOCs. Most participants were infected with the Delta (49.8%) or Alpha (28.6%) VOCs.^[255]
Sotrovimab	EUA stopped owing to resistance to Omicron BA.2 subvariant. Initial IV and IM authorization based on COMET-ICE and COMET-TAIL studies.^{[256, 257]}
Casirivimab/imdevimab	EUA stopped in January 2022, as the Omicron variant is not susceptible. The EUA for treatment was supported by US trials and the UK RECOVERY trial.^{[258, 259, 260]}
Bamlanivimab/etesevimab	EUA revoked in April 2021 as the Delta VOC emerged. Initial EUA was supported by Phase 3 BLAZE-1 trial for treatment and the BLAZE-2 trial for postexposure prophylaxis.^{[261, 262]}

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Author

David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS Associate Professor of Medicine and Pediatrics, Adult and Pediatric Infectious Diseases, Rutgers New Jersey Medical School

David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS is a member of the following medical societies: American Academy of HIV Medicine, American Academy of Pediatrics, American College of Physicians, American Medical Association, HIV Medicine Association, Infectious Diseases Society of America, Medical Society of New Jersey, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Coauthor(s)

Scott J Bergman, PharmD, FCCP, FIDSA, BCPS, BCIDP Antimicrobial Stewardship Program Coordinator, Infectious Diseases Pharmacy Residency Program Director, Department of Pharmaceutical and Nutrition Care, Division of Infectious Diseases, Nebraska Medicine; Clinical Associate Professor, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center

Scott J Bergman, PharmD, FCCP, FIDSA, BCPS, BCIDP is a member of the following medical societies: American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, American Pharmacists Association, American Society for Microbiology, American Society of Health-System Pharmacists, Infectious Diseases Society of America, Society of Infectious Diseases Pharmacists

Disclosure: Received research grant from: Merck & Co., Inc.

Keith M Olsen, PharmD, FCCP, FCCM Dean and Professor, College of Pharmacy, University of Nebraska Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America; Fellow of the Royal College of Physicians, London

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Molly Marie Miller, PharmD Clinical Infectious Diseases Pharmacist Practitioner, Nebraska Medicine

Molly Marie Miller, PharmD is a member of the following medical societies: American College of Clinical Pharmacy, Society of Infectious Diseases Pharmacists

Disclosure: Nothing to disclose.

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