Practice Points Developed for Treatment of Outpatient COVID-19

Molnupiravir and nirmatrelvir-ritonavir combination therapy should be considered for patients within five days of symptom onset
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Medically Reviewed By:
Mark Arredondo, M.D.
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WEDNESDAY, Sept. 20, 2023 (HealthDay News) -- In an updated clinical guideline issued by the American College of Physicians and published online Sept. 19 in the Annals of Internal Medicine, living, rapid practice points are presented for the outpatient treatment of confirmed COVID-19.

Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues developed living, rapid practice points focusing on 22 outpatient treatments for COVID-19, specifically relating to the omicron variant.

The authors note that molnupiravir should be considered for treating symptomatic patients with confirmed mild-to-moderate COVID-19 in the outpatient setting who are within five days of symptom onset and who have a high risk for progression to severe disease. For symptomatic patients with mild-to-moderate COVID-19 in the outpatient setting who are within five days of symptom onset and have a high risk for progression to severe disease, nirmatrelvir-ritonavir combination therapy should also be considered. Ivermectin should not be used for patients with confirmed mild-to-moderate COVID-19 in the outpatient setting. Sotrovimab should also not be used for patients with confirmed mild-to-moderate COVID-19 in the outpatient setting.

"More research evaluating the efficacy, effectiveness, and comparative effectiveness, as well as harms, of pharmacologic and biologic treatments of COVID-19 in the outpatient setting is needed, particularly in the context of changing dominant severe acute respiratory syndrome coronavirus 2 variants and subvariants," the authors write.

One author disclosed financial ties to Eli Lilly.

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