Remdesivir and ritonavir-boosted nirmatrelvir (Paxlovid) are approved by the Food and Drug Administration for the treatment of COVID-19.
Molnupiravir and high-titer COVID-19 convalescent plasma (CCP) are available only under Food and Drug Administration Emergency Use Authorizations for the treatment of COVID-19.
|Summary Recommendations |
Recommendations for Treating Nonhospitalized Adults
The COVID-19 Treatment Guidelines Panel (the Panel) recommends the following anti-SARS-CoV-2 therapies as preferred treatments for COVID-19. These drugs are listed in order of preference:
The Panel recommends molnupiravir as an alternative therapy when neither of the preferred therapies are available, feasible to use, or clinically appropriate (CIIa).
Recommendations for Treating Nonhospitalized Children
Recommendations for Treating Hospitalized Adults or Children
Antiviral Treatments With Insufficient Evidence
- There is insufficient evidence for the Panel to recommend either for or against the use of high-titer CCP for the treatment of COVID-19 in hospitalized or nonhospitalized patients who are immunocompromised.
- There is insufficient evidence for the Panel to recommend either for or against the use of high-titer CCP for the treatment of COVID-19 in nonhospitalized patients who are immunocompetent.
Antiviral Treatments That the Panel Recommends Against
- The Panel recommends against the use of the following drugs for the treatment of COVID-19, except in a clinical trial:
- Interferon alfa or beta in nonhospitalized patients (AIIa)
- Interferon alfa in hospitalized patients (AIIa)
- Nitazoxanide (BIIa)
- The Panel recommends against the use of the following drugs for the treatment of COVID-19:
- Anti-SARS-CoV-2 monoclonal antibodies (AIII)
- Chloroquine or hydroxychloroquine and/or azithromycin in hospitalized (AI) and nonhospitalized patients (AIIa)
- CCP in hospitalized patients who are immunocompetent (AI)
- Lopinavir/ritonavir and other HIV protease inhibitors in hospitalized (AI) and nonhospitalized patients (AIII)
- Systemic interferon beta in hospitalized patients (AI)
COVID-19 Pre-Exposure Prophylaxis
- The Panel recommends against the use of tixagevimab plus cilgavimab (Evusheld) as pre-exposure prophylaxis (PrEP) of COVID-19 (AIII).
The sections on Chloroquine or Hydroxychloroquine and/or Azithromycin, Lopinavir/Ritonavir and Other HIV Protease Inhibitors, and Nitazoxanide have been archived. The Panel will no longer be updating the information on these therapies.
|Each recommendation in the Guidelines receives a rating for the strength of the recommendation (A, B, or C) and a rating for the evidence that supports it (I, IIa, IIb, or III). See Guidelines Development for more information.|