What are the recommended treatments for COVID-19 (Coronavirus Disease 2019) at home?

COVID-19 Home Treatment

For mild COVID-19 managed at home, focus on supportive care with paracetamol for fever, adequate hydration, rest, and strict isolation precautions, while monitoring closely for signs of deterioration that require immediate hospital evaluation. 1

Symptomatic Management

Fever Control

• Use paracetamol (acetaminophen) as the preferred antipyretic rather than NSAIDs for fever and symptom relief 1
• Take paracetamol only while fever and symptoms are present, not routinely to reduce body temperature 1
• Note that fever typically peaks around day 5 after exposure, requiring close monitoring during this period 1
• Consider that fever is an evolved defense mechanism that may benefit viral clearance, so aggressive suppression may not always be optimal 2

Cough Management

• Honey is recommended as first-line treatment for cough in adults 1
• Avoid lying flat on your back, as this makes coughing ineffective 1
• If cough becomes distressing despite simple measures, consider short-term use of codeine linctus, codeine phosphate tablets, or morphine sulfate oral solution 1

Breathlessness Management

• Teach controlled breathing techniques, including pursed-lip breathing 1
• Sit upright to increase peak ventilation and lean forward with arms bracing to improve ventilatory capacity 1
• Relax and drop shoulders to reduce anxiety-related hunched posture that worsens breathlessness 1

Supportive Care Measures

Hydration and Nutrition

• Ensure adequate hydration with regular fluid intake, limited to no more than 2 liters per day 1
• Maintain nutritional support with protein-rich foods, with ideal energy intake of 25-30 kcal/(kg·day) and protein intake of 1.5 g/(kg·day) 1
• Bed rest is recommended during the acute phase 1

Monitoring Requirements

• Monitor vital signs including heart rate, pulse oximetry, respiratory rate, and blood pressure 1
• Healthcare personnel should perform regular (daily) follow-up through face-to-face visits or phone interviews to follow symptom progression 3
• Closely record medication use and symptoms, with caregivers monitoring body temperature daily 3

Isolation and Infection Control

Patient Isolation (Strong Recommendations)

• Isolate in a well-ventilated single room 3
• Maintain a bed distance of at least 1 meter from others 3
• Restrict the patient's activity 3
• Limit visits by relatives and friends 3
• Wear a medical mask when coughing or sneezing, or cover with a paper towel and bent elbow, cleaning hands immediately afterward 3

Environmental Precautions

• Clean and disinfect household articles using 500 mg/L chlorine-containing disinfectant frequently every day 3
• Open windows for ventilation in shared areas such as toilets and kitchens 3
• Avoid sharing toothbrush, towel, tableware, bed sheets and other items with patients 3
• Patient's daily necessities should be for single use only and placed separately from family members' items 3

Caregiver Protection

• Caregivers should wear N95 masks when in the same room with patients (preferred strategy) 3
• Disposable surgical masks are an alternative strategy 3
• The caregiver should be a healthy family member without underlying diseases 3
• Clean and disinfect hands after contact with the patient, before leaving patient's room, before and after eating, after using the toilet, and after entering house from outside 3
• Avoid direct contact with patient's secretions or discharges, especially oral or respiratory discharges and feces 3
• Wear disposable gloves (double layers) when providing oral and respiratory care, handling feces and urine, and cleaning the patient's room 3

Laundry and Waste Management

• Wash patient's clothes, bed sheets, bath towels, and towels with ordinary washing soap and water, or use a washing machine at 60–90°C with ordinary household washing liquid 3
• Put contaminated bedding into a laundry bag without shaking contaminated clothing 3
• Put waste generated by the patient into closed garbage bags and replace frequently 3

Red Flags Requiring Immediate Medical Attention

Seek immediate hospital evaluation if any of the following develop:

• Worsening breathlessness or respiratory rate ≥30 breaths/min 3, 1
• Persistent chest pain 1
• Confusion or inability to stay awake 1
• Oxygen saturation <94% on room air (or ≤93% at rest) 3, 1
• Progressive worsening of symptoms despite home care 3

What NOT to Do

Avoid Inappropriate Medications

• Avoid blind or inappropriate use of antibacterial drugs unless there is clear evidence of secondary bacterial infection 1
• Do not use corticosteroids for mild COVID-19, as they may prolong viral clearance time and increase mortality in non-severe cases 3
• Hydroxychloroquine is not recommended, as it does not improve outcomes and may increase adverse events 3
• Lopinavir/ritonavir alone is not recommended for mild cases due to lack of benefit and increased risk of gastrointestinal side effects 3

Important Caveats

• Home care requires careful clinical evaluation and safety assessment by healthcare professionals to determine appropriateness 3
• This approach is only suitable for suspected or confirmed mild cases without risk factors for severe disease 3
• Establish a treatment escalation plan immediately, as COVID-19 patients can deteriorate rapidly and require urgent hospital admission 1
• The 14-day observation period should be strictly followed from the last day of exposure 3