COVID-19: Medication therapy - Revision history

Rossdonaldson1: Redirected page to COVID-19#Management by Patient Category

2022-01-18T20:11:17Z

Redirected page to COVID-19#Management by Patient Category

← Older revision		Revision as of 20:11, 18 January 2022
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	~~==Background==~~		#REDIRECT[[COVID-19#Management_by_Patient_Category]]
	*As of December 2020, there is currently only a single FDA-approved therapeutic for the treatment
	**However, there are many therapeutics that have been considered for therapy and available for off-label use and through FDA Emergency-Use-Authorization.

	~~==Evidence Supported Acute Therapies==~~
	~~{{COVID Dex}}~~
	~~{{COVID Remdesivir}}~~

	~~==Investigational Therapies==~~
	~~''NIH panel does not recommend initiation of any investigational therapies outside of a clinical trial<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>''~~

	~~===[[Antivirals]]===~~
	~~===Chloroquine or Hydroxychloroquine With or Without Azithromycin===~~
	*FDA cautions '''against''' use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems<ref>https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or</ref>
	*NIH panel recommends '''against''' the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19 in hospitalized patients.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*In nonhospitalized patients, the Panel recommends '''against''' the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*NIH panel recommends '''against''' the use of high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>

	~~===Lopinavir/Ritonavir and Other HIV Protease Inhibitors===~~
	*NIH Panel recommends '''against''' using lopinavir/ritonavir (AI) or other HIV protease inhibitors to treat COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*Known in the U.S as Kaletra, this HIV medication has been widely used in China to treat COVID patients.<ref>https://www.reuters.com/article/us-health-coronavirus-china-wuhan-hospit/key-china-coronavirus-hospital-says-hiv-drug-beneficial-to-patients-idUSKCN21R1LX</ref>.
	*An RCT with 199 confirmed COVID-19 positive patients concluded that there was no benefit to treating hospitalized patients with [[Lopinavir]]/[[Ritonavir]] versus supportive care.<ref>Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., ... & Li, X. (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.</ref>
	*<b>Dose:</b> 400/100mg BID x 10 days. <ref>https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/mass-general-COVID-19-treatment-guidance.pdf</ref>

	~~===Ivermectin===~~
	*NIH Panel recommends '''against''' the use of ivermectin for the treatment of COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>

	~~====~~[[~~Oseltamivir]]====~~
	*Coronaviruses do not utilize neuraminidase for the budding stage of reproduction and therefore no activity is expected.
	*Several small trials have not shown any benefit in patients with COVID-19~~. <ref>Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. E-pub Date: aheadofprint February 2020.~~
	~~DOI~~ # ~~10.1001/jama.2020.1585 . https://www.ncbi.nlm.nih.gov/pubmed/32031570 </ref>~~

	~~====[[Baloxavir marboxil]]====~~
	*Several clinical trials are underway however there is '''no evidence''' at this time for the efficacy of [[Baloxavir marboxil]] in treating COVID-19

	~~====[[Favipiravir]]====~~
	*A small, open label, non-randomized trial in China has shown promising results and has not been peer reviewed.<ref>https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19</ref>
	*A small prospective, open label study conducted in China has shown promise in symptom reduction for moderately ill patients with COVID-19 and has not yet been peer reviewed <ref>https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3</ref>

	~~====[[Ribavirin]]====~~
	*Has been used in patients with [[MERS]] with inconclusive results.<ref>Arabi YM, et al. Ribavirin and Interferon Therapy for Critically Ill Patients With Middle East Respiratory Syndrome: A Multicenter
	~~Observational Study. Clin Infect Dis. 2019 Jun 25. https://www.ncbi.nlm.nih.gov/pubmed/31925415.</ref>~~
	*Small trials in China and North America have failed to establish a therapeutic benefit of Ribavirin. <ref>Devaux CA1, Rolain JM2, Colson P2, Raoult D2. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?. Int J Antimicrob Agents. 2020 Mar 12:105938. doi: 10.1016/j.ijantimicag.2020.105938.</ref>

	~~====[[Azithromycin]]====~~
	*Macrolide antibiotic with purported anti-inflammatory effects in certain respiratory conditions such as [[COPD]].
	*A small French study with 20 patients showed benefit in reducing symptoms and viral carriage when combined with [[Hydroxychloroquine]]. <ref>Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020:105949. [PMID: 32205204] doi:10.1016/j.ijantimicag.2020.105949 </ref>
	*Recommended if there is concern for bacterial superinfection<ref>https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/mass-general-COVID-19-treatment-guidance.pdf</ref>
	*'''Dosage:''' 500mg x 1 day. Then 250mg x 4 days.

	~~===Immunomodulators===~~
	~~====[[Interferon]]====~~
	*Typically used in combination with ribavirin, interferons have been studied for patients with other coronaviruses, with mixed results. Their adverse effect profiles are also generally unfavorable.

	~~===[[Tocilizumab]]===~~
	*FDA approved Interleukin-6 (IL-6) monoclonal antibody receptor antagonist used to treat rheumatoid arthritis and cytokine release storm syndrome.
	*Multiple anecdotal reports and cases showing marked improvement in oxygenation and clinical outcome after drug administration.<ref>Xu X et al. Effective Treatment of Severe COVID-19 Patients with Tocilizumab. Unpublished study. 2020) https://www.ser.es/wp-content/uploads/2020/03/TCZ-and-COVID-19.pdf</ref> <ref> Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. Published online April 13, 2020. doi:10.1001/jama.2020.6019 </ref>
	*FDA approved randomized double-blinded clinical trial under way to evaluate its safety and efficacy. <ref> “Roche Initiates Phase III Clinical Trial of Actemra/RoActemra in Hospitalised Patients with Severe COVID-19 Pneumonia.” Roche, www.roche.com/media/releases/med-cor-2020-03-19.htm.</ref>
	*'''Dosage:''' Typically 8 mg/kg single dose, though some reports suggest giving repeated dosages in critically ill patients. <ref> Luo, Pan. “Tocilizumab Treatment in COVID-19: A Single Center Experience.” Journal of Medical Virology, 2020, doi:10.1002/jmv.25801.</ref>

	~~===[[Convalescent Plasma]]===~~
	*Prior studies with convalescent plasma involving SARS, H1N1, and Ebola have had proven benefit in critically ill patients. <ref>Chen, Long et al. “Convalescent plasma as a potential therapy for COVID-19.” The Lancet. Infectious diseases vol. 20,4 (2020): 398-400. doi:10.1016/S1473-3099(20)30141-9 </ref>
	*Involves obtaining plasma/antibodies from patients who have recovered from COVID-19 and injecting them into critically ill patients.
	*Shown to have possible clinical improvement in patients with severe ARDS and COVID-19. <ref> “Shen C, Wang Z, Zhao F, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783” </ref>

	~~===[[Anticoagulation]]===~~
	*Anticoagulation may be associated with lower mortality due to COVID-19 associated vascular thromboemboli resulting in increased dead space ventilation. <ref>Tang et al. J Thromb Haemost 2020 Mar 27. PMID: 32220112 </ref>
	*Do not give anticoagulation to patients who have a high risk of bleeding as judged by the treating physician.
	*Before starting anticoagulation, check cbc, pt/ptt, d-dimer. Hold anticoagulation if platelet count <50,000 or INR >1.5.
	*In admitted patients with moderate or severe COVID-19:
	*High risk: No definitive criteria, but clinician should use a combination of respiratory distress, o2 requirement, elevated d-dimer, creatinine, and crp in making determination.

	~~====Dosing====~~
	*ICU: Heparin drip per PE protocol (goal PTT 70 - 110) or Enoxaparin SC 1mg/kg BID.
	*High risk admitted patients:
	**CrCl > 50: [[Enoxaparin]] SC 1m/kg BID
	**CrCl <50:
	***On renal replacement Therapy: [[Apixaban]] 5mg PO BID or heparin drip PE protocol.
	***Not on renal replacement Therapy: [[Apixaban]] 5mg PO BID or Adjusted Dose Enoxaparin.
	*Not high risk:
	**[[Apixaban]] 2.5-5.0mg PO BID or Enoxaparin SC 40mg QD.

	~~===Other experimental agents===~~
	*[[IVIG]]

	~~{{COVID contraindicated therapies}}~~

	~~==[[COVID-19 vaccines]]==~~
	~~See:~~
	*[[COVID-19 Vaccine (Moderna)]]
	*[[COVID-19 Vaccine (Pfizer-BioNTech)]]

	~~==See Also==~~
	~~{{Special:Prefixindex/COVID-19 \|hideredirects=1}}~~

	~~==External Links==~~
	*https://www.covid19treatmentguidelines.nih.gov/

	~~==References==~~

	~~[[Category:COVID-19~~]]

Rossdonaldson1: /* Convalescent Plasma */

2021-01-16T13:43:54Z

Convalescent Plasma

← Older revision		Revision as of 13:43, 16 January 2021
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	*Involves obtaining plasma/antibodies from patients who have recovered from COVID-19 and injecting them into critically ill patients.		*Involves obtaining plasma/antibodies from patients who have recovered from COVID-19 and injecting them into critically ill patients.
	*Shown to have possible clinical improvement in patients with severe ARDS and COVID-19. <ref> “Shen C, Wang Z, Zhao F, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783” </ref>		*Shown to have possible clinical improvement in patients with severe ARDS and COVID-19. <ref> “Shen C, Wang Z, Zhao F, et al. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783” </ref>


	===[[Anticoagulation]]===		===[[Anticoagulation]]===

Rossdonaldson1 at 13:38, 16 January 2021

2021-01-16T13:38:51Z

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	==Evidence Supported Acute Therapies==		==Evidence Supported Acute Therapies==
	{{COVID Dex}}		{{COVID Dex}}
			{{COVID Remdesivir}}
	~~====[[Remdesivir]]====~~
	*Indication<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>
	**SpO2≤94% on ambient air (at sea level) or requiring supplemental oxygen via low flow device
	**There is insufficient data to recommend for or against use in patients using high flow oxygen, mechanical ventilation or ECMO (NIH COVID~~-19 Guidelines).~~
	*Should typically be given for 5 days, or until the time of hospital discharge, whichever comes first. Home IV therapy is not recommended.
	*Contraindications<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>
	**Alanine transaminase or aspartate transaminase >5 times the upper limit of normal
	**Creatinine clearance of <30 mL/minute
	***There is limited data to suggest that remdesivir can be considered in patients with calculated creatinine clearance of <30 mL/minute and in patients receiving hemodialysis if the benefits outweigh the risk. At this time, there are no recommended dose adjustments for this patient population.
	**Pediatric patients 3.5kg to 12 years of age, Remdesivir ~~should not be given if ALT is >10 times normal.~~

	==Investigational Therapies==		==Investigational Therapies==

Rossdonaldson1: /* Evidence Supported Acute Therapies */

2021-01-16T13:35:38Z

Evidence Supported Acute Therapies

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	==Evidence Supported Acute Therapies==		==Evidence Supported Acute Therapies==
	~~===[[Dexamethasone]]===~~		{{COVID Dex}}
	*Dosage: 6mg Qday
	**Dexamethasone improves 28d mortality compared to placebo in patients requiring IMV (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).
	**There was no benefit to patients not requiring oxygenation support and potentially harm

	====[[Remdesivir]]====		====[[Remdesivir]]====

Rossdonaldson1: /* Remdesivir */

2021-01-16T12:25:38Z

Remdesivir

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	**SpO2≤94% on ambient air (at sea level) or requiring supplemental oxygen via low flow device		**SpO2≤94% on ambient air (at sea level) or requiring supplemental oxygen via low flow device
	**There is insufficient data to recommend for or against use in patients using high flow oxygen, mechanical ventilation or ECMO (NIH COVID-19 Guidelines).		**There is insufficient data to recommend for or against use in patients using high flow oxygen, mechanical ventilation or ECMO (NIH COVID-19 Guidelines).
	*As of November 2020, WHO recommends against the use of remdesivir in COVID-19 patients, regardless of disease severity<ref>https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients</ref>
	*Should typically be given for 5 days, or until the time of hospital discharge, whichever comes first. Home IV therapy is not recommended.		*Should typically be given for 5 days, or until the time of hospital discharge, whichever comes first. Home IV therapy is not recommended.
	*Contraindications<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>		*Contraindications<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>

Rossdonaldson1: /* Evidence Supported Acute Therapies */

2021-01-16T12:25:18Z

Evidence Supported Acute Therapies

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	====[[Remdesivir]]====		====[[Remdesivir]]====
	*~~Previously used to treat Ebola~~<ref>~~Auwaerter~~. ~~Johns Hopkins Antibiotic guide~~. ~~Coronavirus COVID~~-~~19. April 8 2020~~</ref> ~~this medication inhibits viral RNA polymerase and has shown some promisinng invitro activity against [[SARS-CoV-2]].~~		*Indication<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>
	*~~A recent small study among 53 patients with severe symptoms from COVID-19 were given [[Remdesivir]]~~ for ~~compassionate~~ use~~. 68% percent of~~ patients ~~showed some clinical improvement.<ref>Grein, J., Ohmagari, N.,...Oda~~, R (~~2020). Compassionate Use of Remdesivir for Patients with Severe~~ COVID-19. ~~New England Journal of Medicine.</ref>~~		**SpO2≤94% on ambient air (at sea level) or requiring supplemental oxygen via low flow device
	*A large NIH funded trial is currently underway to assess the efficacy of this medication <ref>https://clinicaltrials.gov/ct2/show/NCT04280705</ref>		**There is insufficient data to recommend for or against use in patients using high flow oxygen, mechanical ventilation or ECMO (NIH COVID-19 Guidelines).
	*Consider using in hospitalized patients with severe symptoms and significant Oxygen requirements
	*As of November 2020, WHO recommends against the use of remdesivir in COVID-19 patients, regardless of disease severity<ref>https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients</ref>		*As of November 2020, WHO recommends against the use of remdesivir in COVID-19 patients, regardless of disease severity<ref>https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients</ref>
	*~~Contact Gilead directly~~ for ~~use: compassionateaccess@gilead.com~~		*Should typically be given for 5 days, or until the time of hospital discharge, whichever comes first. Home IV therapy is not recommended.
	*<b>Dose:</b> 200mg IV one time. ~~Then 100mg~~ IV ~~once daily for 10 days~~. <ref>https://www.~~massgeneral~~.~~org~~/~~assets/MGH/pdf~~/~~news~~/~~coronavirus/mass-general-COVID-19-treatment-guidance.pdf~~</ref>		*Contraindications<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/</ref>
			**Alanine transaminase or aspartate transaminase >5 times the upper limit of normal
			**Creatinine clearance of <30 mL/minute
	*'''[[Remdesivir]] (IV)'''		***There is limited data to suggest that remdesivir can be considered in patients with calculated creatinine clearance of <30 mL/minute and in patients receiving hemodialysis if the benefits outweigh the risk. At this time, there are no recommended dose adjustments for this patient population.
	**~~Consider for severely hypoxemic (Mechanical vent, high PEEP, FiO2 requirements~~ >~~40%,).~~		**Pediatric patients 3.5kg to 12 years of age, Remdesivir should not be given if ALT is >10 times normal.
	** ~~Contact Gilead directly for use: compassionateaccess@gilead.com~~
	** ~~Background: novel antiviral nucleotide analog. Initially developed for Ebola and Marburg (has since been found~~ to ~~show activity against other single stranded RNA viruses such as RSV, Lassa fever virus, Nipah virus~~ and the ~~coronaviruses including MERS and SARS)~~
	*** 3 ~~clinical trials across country (one~~ is ~~NIH adaptive trial)~~
	*** 2 other trials are investigational open-label trials testing different dosages for moderate or severely hospitalized patients

	==Investigational Therapies==		==Investigational Therapies==

Rossdonaldson1: /* Investigational Therapies */

2021-01-16T12:16:51Z

Investigational Therapies

Rossdonaldson1: /* Investigational Therapies */

2021-01-16T12:15:32Z

Investigational Therapies

← Older revision		Revision as of 12:15, 16 January 2021
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	==Investigational Therapies==		==Investigational Therapies==
	''~~Generally not started in ED setting; CDC~~ does not recommend ~~for or against~~ any investigational therapies ~~at this time~~''		''NIH panel does not recommend initiation of any investigational therapies outside of a clinical trial<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>''

	===[[Antivirals]]===		===[[Antivirals]]===

Rossdonaldson1 at 12:14, 16 January 2021

2021-01-16T12:14:26Z

@@ Line 8: / Line 8: @@
 **Dexamethasone improves 28d mortality compared to placebo in patients requiring IMV (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).
 **There was no benefit to patients not requiring oxygenation support and potentially harm
 ====[[Remdesivir]]====
@@ Line 34: / Line 25: @@
 *** 3 clinical trials across country (one is NIH adaptive trial)
 *** 2 other trials are investigational open-label trials testing different dosages for moderate or severely hospitalized patients
 ====[[Oseltamivir]]====
@@ Line 51: / Line 61: @@
 Observational Study. Clin Infect Dis. 2019 Jun 25. https://www.ncbi.nlm.nih.gov/pubmed/31925415.</ref>
 *Small trials in China and North America have failed to establish a therapeutic benefit of Ribavirin. <ref>Devaux CA1, Rolain JM2, Colson P2, Raoult D2. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?. Int J Antimicrob Agents. 2020 Mar 12:105938. doi: 10.1016/j.ijantimicag.2020.105938.</ref>
 ====[[Azithromycin]]====

Rossdonaldson1: /* See Also */

2021-01-16T12:08:02Z

← Older revision		Revision as of 12:16, 16 January 2021
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	===[[Antivirals]]===		===[[Antivirals]]===
	===Chloroquine or Hydroxychloroquine With or Without Azithromycin===		===Chloroquine or Hydroxychloroquine With or Without Azithromycin===
	*FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems<ref>https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or</ref>		*FDA cautions '''against''' use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems<ref>https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or</ref>
	*NIH panel recommends '''against''' the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19 in hospitalized patients.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>		*NIH panel recommends '''against''' the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19 in hospitalized patients.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*In nonhospitalized patients, the Panel recommends against the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>		*In nonhospitalized patients, the Panel recommends '''against''' the use of chloroquine or hydroxychloroquine with or without azithromycin for the treatment of COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*NIH panel recommends against the use of high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>		*NIH panel recommends '''against''' the use of high-dose chloroquine (600 mg twice daily for 10 days) for the treatment of COVID-19.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>

	===Lopinavir/Ritonavir and Other HIV Protease Inhibitors===		===Lopinavir/Ritonavir and Other HIV Protease Inhibitors===
	*NIH Panel recommends against using lopinavir/ritonavir (AI) or other HIV protease inhibitors to treat COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>		*NIH Panel recommends '''against''' using lopinavir/ritonavir (AI) or other HIV protease inhibitors to treat COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>
	*Known in the U.S as Kaletra, this HIV medication has been widely used in China to treat COVID patients.<ref>https://www.reuters.com/article/us-health-coronavirus-china-wuhan-hospit/key-china-coronavirus-hospital-says-hiv-drug-beneficial-to-patients-idUSKCN21R1LX</ref>.		*Known in the U.S as Kaletra, this HIV medication has been widely used in China to treat COVID patients.<ref>https://www.reuters.com/article/us-health-coronavirus-china-wuhan-hospit/key-china-coronavirus-hospital-says-hiv-drug-beneficial-to-patients-idUSKCN21R1LX</ref>.
	*An RCT with 199 confirmed COVID-19 positive patients concluded that there was no benefit to treating hospitalized patients with [[Lopinavir]]/[[Ritonavir]] versus supportive care.<ref>Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., ... & Li, X. (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.</ref>		*An RCT with 199 confirmed COVID-19 positive patients concluded that there was no benefit to treating hospitalized patients with [[Lopinavir]]/[[Ritonavir]] versus supportive care.<ref>Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., ... & Li, X. (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.</ref>
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	===Ivermectin===		===Ivermectin===
	*~~The~~ Panel recommends against the use of ivermectin for the treatment of COVID-19, except in a clinical trial.		*NIH Panel recommends '''against''' the use of ivermectin for the treatment of COVID-19, except in a clinical trial.<ref>https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/</ref>

	====[[Oseltamivir]]====		====[[Oseltamivir]]====
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	====[[Baloxavir marboxil]]====		====[[Baloxavir marboxil]]====
	*Several clinical trials are underway however there is no evidence at this time for the efficacy of [[Baloxavir marboxil]] in treating COVID-19		*Several clinical trials are underway however there is '''no evidence''' at this time for the efficacy of [[Baloxavir marboxil]] in treating COVID-19

	====[[Favipiravir]]====		====[[Favipiravir]]====
	*A small, open label, non-randomized trial in China has shown promising results and has not been peer reviewed.<ref>https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19</ref>		*A small, open label, non-randomized trial in China has shown promising results and has not been peer reviewed.<ref>https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19</ref>
	*A small prospective, open label study conducted in China has shown promise in symptom reduction for ~~moderatly~~ ill patients with COVID-19 and has not yet been peer reviewed <ref>https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3</ref>		*A small prospective, open label study conducted in China has shown promise in symptom reduction for moderately ill patients with COVID-19 and has not yet been peer reviewed <ref>https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3</ref>

	====[[Ribavirin]]====		====[[Ribavirin]]====

← Older revision		Revision as of 12:08, 16 January 2021
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	==See Also==		==See Also==
	{{Special:Prefixindex/COVID-19 \|hideredirects=1}}		{{Special:Prefixindex/COVID-19 \|hideredirects=1}}

			==External Links==
			*https://www.covid19treatmentguidelines.nih.gov/

	==References==		==References==

	[[Category:COVID-19]]		[[Category:COVID-19]]