Expert U.S. panel develops NIH treatment guidelines for COVID-19

April 28, 2020

A panel of U.S. physicians, statisticians and other experts has developed treatment guidelines for coronavirus disease 2019 (COVID-19). These guidelines, intended for health care providers, are based on published and preliminary data and the clinical expertise of the panelists, many of whom are frontline clinicians caring for patients during the rapidly evolving pandemic.

The guidelines will be updated often as new information is published in peer-reviewed scientific literature and other authoritative information emerges.

The guidelines consider two broad categories of therapies currently in use by health care providers for COVID-19: antivirals, which may target the coronavirus directly, and host modifiers and immune-based therapies, which may influence the immune response to the virus or target the virus.

The panel’s conclusions about treating COVID-19 with various agents that fall into these two classes of therapies are distilled in summary recommendations. The document also provides background information about each agent—such as clinical data about its use, ongoing clinical trials and known interactions with other drugs—that forms the basis for the recommendation.

The guidelines also describe the evaluation and stratification of patients based on their risk of infection and severity of illness. A comprehensive section of the guidelines addresses a range of considerations for clinicians caring for the most critically ill hospitalized patients. This section includes multiple recommendations for patients needing critical care, including infection control procedures, hemodynamic and ventilatory support, and drug therapy.

Finally, the guidelines include recommendations concerning the use of concomitant medications. These include statins, corticosteroids, non-steroidal anti-inflammatory drugs, and certain drugs used to control hypertension, known as ACE inhibitors and ARBs.

Summary Recommendations

  • The COVID-19 Treatment Guidelines Panel does not recommend the use of any agents for pre-exposure prophylaxis (PrEP) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outside of the setting of a clinical trial.
  • The panel does not recommend the use of any agents for post-exposure prophylaxis (PEP) against SARS-CoV-2 infection outside of the setting of a clinical trial.
  • The panel recommends no additional laboratory testing and no specific treatment for persons with suspected or confirmed asymptomatic or presymptomatic SARS-CoV-2 infection.
  • At present, no drug has been proven to be safe and effective for treating COVID-19. There are insufficient data to recommend either for or against the use of any antiviral or immunomodulatory therapy in patients with COVID-19 who have mild, moderate, severe or critical illness.

Click here to view the full guidelines.


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