Updated COVID-19 Treatment Guidelines

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The COVID-19 Treatment Guidelines Panel (the Panel) has published a new version of the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines.

As part of this update, the Anti-SARS-CoV-2 Monoclonal Antibodies section has been revised to incorporate information that was previously included in the Panel’s anti-SARS-CoV-2 monoclonal antibody statements. The changes to this section include:

·  Adding sotrovimab as a recommended treatment for nonhospitalized patients with mild to moderate COVID-19 who are at high risk for clinical progression.

·  Revising the dosing and administration information for casirivimab plus imdevimab.

·  Recommending against the use of bamlanivimab plus etesevimab at this time because the Gamma (P.1) and Beta (B.1.351) variants of concern (VoC), which have reduced susceptibility to both agents, are circulating in the United States.

·  Discussing the Food and Drug Administration’s decision to revise the Emergency Use Authorizations for anti-SARS-CoV-2 monoclonal antibodies to include a broader range of conditions that place patients at high risk for clinical progression.

·  Clarifying and updating the discussion on using anti-SARS-CoV-2 monoclonal antibodies in patients who are hospitalized for severe COVID-19.

·  Updating the information on the in vitro susceptibility of circulating VoC and variants of interest to different anti-SARS-CoV-2 monoclonal antibodies, as well as the potential activities of these antibodies against these variants. The Panel has also added a new table to the section to summarize this information.

In addition, the Corticosteroids section now includes a discussion on the use of inhaled corticosteroids in non-hospitalized patients with COVID-19. Based on available clinical trial data, the Panel has determined that there is currently insufficient evidence to recommend either for or against the use of inhaled budesonide for the treatment of COVID-19.