To be eligible for the study, participants had to have been diagnosed with mild to moderate COVID-19, have started experiencing symptoms no more than five days prior to study enrolment, and have at least one risk factor that put them at increased risk of a poor COVID-19 outcome.Based on these data, the Expert Group advises against the use of dexamethasone (AIIa) or other corticosteroids (AIII) for the treatment of COVID-19 in this subgroup, unless the patient has another indication for corticosteroid treatment. Patients taking molnupiravir were half as likely to be hospitalised or die from COVID-19 as those taking placebo. Health system administrators should be aware that several of these agents are intended for outpatient intravenous infusion and be prepared to provide such care in a place and in a manner in which patients with COVID-19 can be safely managed. In any given year, we collectively catch one billion colds and up to 45 million cases of influenza, while the number of new cases of COVID-19 continues to rise.
In the study, more than 6,000 hospitalised patients with COVID-19 randomly received either dexamethasone or standard treatment. The study compared treatment with Regeneron monoclonal antibodies plus standard care with standard care alone in people hospitalised with COVID-19.Approximately half of the study participants took the antiviral drug molnupiravir; four capsules, twice a day, for five days, by mouth. Preliminary data suggest that hospitalised patients with mild to moderate disease have a survival benefit with this treatment. The Panel recommends against the use of the combination of baricitinib and tocilizumab for the treatment of COVID-19, except in one clinical trial (AIII), because there is insufficient evidence for the use of this combination.
Recruitment occurred within 24 hours of ICU admission and within a median of 1.2 days of hospitalisation (IQR 0.8-2.8 days), suggesting that the benefit of tocilizumab occurs in patients experiencing rapid respiratory decompensation. Clinicians and patients wishing to consider its use, or the use of any other available investigational therapy, should review the external COVID-19 Icon Treatment Guideline, as well as the FDA's EUA for the therapy. In the placebo group, 53 of 377, or 14.1%, of participants were hospitalised, including eight participants in this group who died. Compared to placebo and standard treatment, convalescent plasma did not significantly improve the risk of death, length of hospital stay or need for a ventilator.
Remdesivir can be given with dexamethasone in hospitalised people who need supplemental oxygen or who are on mechanical ventilation. Treatment has been shown to reduce the likelihood of disease progression and the need for hospitalisation.