From the Guidelines
COVID-19 treatment should prioritize corticosteroids for severe cases, as well as consider tocilizumab for adult patients with high inflammatory markers, and remdesivir for patients receiving oxygen therapy but not on invasive mechanical ventilation (IMV) 1.
Treatment Overview
COVID-19 treatment varies based on severity but typically includes supportive care and specific medications. For mild cases, rest, hydration, and over-the-counter medications like acetaminophen (Tylenol) for fever and pain are recommended.
Medications for Moderate to Severe Cases
For moderate to severe cases requiring hospitalization, treatments may include:
- Remdesivir (typically 200mg IV on day 1, followed by 100mg daily for 4-9 days)
- Dexamethasone (6mg daily for up to 10 days)
- Oxygen therapy as needed
- Monoclonal antibody treatments may be used in specific situations, such as for patients at risk of severe COVID-19 course, with symptom onset <5 days or still seronegative 1
Key Considerations
Treatment effectiveness depends on timing, with antivirals working best early in infection by preventing viral replication, while anti-inflammatory medications like dexamethasone help manage the immune response in later stages.
- Patients should isolate according to current guidelines and seek immediate medical attention if experiencing severe symptoms like difficulty breathing, persistent chest pain, or confusion.
- The use of glucocorticoids and tocilizumab should be considered in patients with COVID-19 requiring supplemental oxygen, non-invasive or mechanical ventilation, as it reduces disease progression and mortality 1.
- The combination of glucocorticoids and baricitinib or tofacitinib could be considered in patients with COVID-19 requiring oxygen therapy, non-invasive ventilation or high-flow oxygen, as it might decrease disease progression and mortality 1.
From the FDA Drug Label
VEKLURY is indicated for the treatment of coronavirus disease 2019 (COVID-19) in adults and pediatric patients (birth to less than 18 years of age weighing at least 1. 5 kg) who are [see Clinical Studies (14)]: Hospitalized, or Not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19, including hospitalization or death. ACTEMRA® (tocilizumab) is indicated for the treatment of coronavirus disease 2019 (COVID-19) in hospitalized adult patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).
Covid treatment options:
- Remdesivir (IV): indicated for the treatment of COVID-19 in adults and pediatric patients (birth to less than 18 years of age weighing at least 1.5 kg) who are hospitalized or not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19.
- Tocilizumab (IV): indicated for the treatment of COVID-19 in hospitalized adult patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) 2, 3.
From the Research
Covid Treatment Overview
- Covid-19 treatment depends on the severity of the disease, with mild cases often manageable at home and severe cases requiring hospital admission and supportive care 4, 5.
- Supportive care for Covid-19 includes oxygen therapy, ventilatory support, and management of complications such as superimposed bacterial infections and underlying comorbidities 4, 6.
Treatment Options
- Antiviral agents such as remdesivir have shown promise in reducing the time to recovery and mortality in Covid-19 patients 7, 8.
- Corticosteroids like dexamethasone have been found to reduce mortality in severe Covid-19 cases 7, 8.
- Janus kinase inhibitors like baricitinib have been used in combination with remdesivir and dexamethasone to target immune dysregulation in Covid-19 patients 7, 8.
Supportive Care
- Noninvasive positive pressure ventilation, continuous positive airway pressure, and high flow oxygenation can be used to support patients with respiratory failure who do not require intubation 6.
- Basic components of supportive care, such as management of fluids, electrolytes, and nutrition, should be applied to patients with Covid-19 in the intensive care unit 6.