Living Guideline Updated for Drug Treatment of COVID-19

MONDAY, April 25, 2022 (HealthDay News) — In the living guideline developed by the World Health Organization and published in The BMJ, recommendations on drug options for the treatment of COVID-19 have been updated.

Arnav Agarwal, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues issued a 10th version of the living guideline on drugs for COVID-19, developing new recommendations for patients with nonsevere COVID-19 and relating to use of nirmatrelvir/ritonavir (two randomized controlled trials [RCTs], with 3,100 participants) and remdesivir (five RCTs, with 2,710 participants).

The authors present a strong recommendation for use of nirmatrelvir/ritonavir in patients with confirmed COVID-19 who have the highest risk for hospitalization, while for patients with a low risk for hospitalization, a conditional recommendation was made against its use. Owing to an absence of trial data, no recommendation was made for nirmatrelvir/ritonavir in patients with severe or critical illness. A conditional recommendation was made for remdesivir for patients with the highest risk for hospitalization; this recommendation replaces a previous conditional recommendation against remdesivir for patients with COVID-19, regardless of disease severity.

“The strong recommendation for nirmatrelvir/ritonavir reflects what the guideline development group considered to represent a superior choice over other treatment options for those with nonsevere illness at highest risk; it may prevent more hospitalizations than the alternatives, has fewer harms than molnupiravir, and is easier to administer than intravenous options such as remdesivir and the monoclonal antibodies,” the authors write.

Abstract/Full Text