Aquatics FAQs
Recommendations for Fully Vaccinated People
COVID-19 Homepage
Interim Clinical Considerations for COVID-19 Treatment in Outpatients
This page provides a treatment overview for healthcare providers.
For General Public: COVID-19 Treatments and Medications
- There is strong scientific evidence that antiviral treatment of outpatients at risk for severe COVID-19 reduces their risk of hospitalization and death.
- The antiviral drugs Paxlovid (ritonavir-boosted nirmatrelvir) and Veklury (remdesivir) are the preferred treatments for eligible adult and pediatric patients with positive results of direct SARS-CoV-2 viral testing and who are at high risk for progression to severe COVID-19.
- Clinicians should consider COVID-19 treatment in non-hospitalized patients who meet all of the following:
- Test positive for SARS-CoV-2 (with PCR or antigen test, including at-home tests)
- Have symptoms consistent with mild-to-moderate COVID-19. People with mild COVID-19 experience symptoms such as fever, sore throat, cough, or headache that do not affect the lungs and breathing. People with moderate illness have symptoms that affect the lungs like shortness of breath or difficulty breathing.
- Are within 5 days of symptom onset for Paxlovid or 7 days of symptom onset for Veklury
- Have one or more risk factors for severe COVID-19
Risk Factors for Severe COVID-19
Age is the most important risk factor for severe outcomes of COVID-19.
Clinicians can use the links below to identify patients at risk for severe COVID-19 and who may benefit from outpatient treatment. Severe outcomes of COVID-19 are defined as hospitalization, intensive care, ventilatory support, or death. There may be other medical conditions associated with severe COVID-19 not listed here, and clinical judgment is needed.
Risk factors for severe COVID-19 include:
- Age over 50 years, with risk increasing substantially at age ≥ 65 years
- Being unvaccinated or not being up to date on COVID-19 vaccinations
- Specific medical conditions and behaviors
Some people from racial and ethnic minority groups are at risk of being disproportionately affected by COVID-19 from many factors, including limited access to vaccines and healthcare.(1-3) Healthcare providers can consider these factors when evaluating the risk for severe COVID-19 and use of outpatient therapeutics.
Outpatient Treatments for COVID-19
Oral Paxlovid (ritonavir-boosted nirmatrelvir)
In a clinical trial, Paxlovid reduced the risk of hospitalization and death by 89% in unvaccinated outpatients with COVID-19 at higher risk of severe disease.(4) Serious adverse events are uncommon with Paxlovid treatment.(4) Paxlovid is given twice daily for 5 days, starting as soon as possible and within 5 days of symptom onset, and is approved for use in adult and pediatric patients (12 years of age and older weighing at least 40kg). Clinicians should be aware of the eligibility criteria and the potential for drug interactions with the use of Paxlovid that may preclude Paxlovid use or may require temporary discontinuation of other medications. COVID-19 rebound has been reported to occur in a small percentage of patients between 2 and 8 days after initial recovery and is characterized by recurrent but milder symptoms and viral detection after having tested negative.
Intravenous Veklury (remdesivir)
Veklury (remdesivir) reduced the risk of hospitalization and death by 87% in unvaccinated outpatients with COVID-19 at higher risk of severe disease.(5) A 3-day course of intravenous remdesivir initiated within 7 days of symptom onset is the second preferred treatment option after Paxlovid for adults and pediatric patients (age >28 days and weight > 3kg).
Alternative Therapies
When Paxlovid or remdesivir are not accessible or clinically appropriate, the monoclonal antibody bebtelovimab or the oral antiviral molnupiravir can be used.(6-7) Clinicians can use the links below to review details on eligibility and indication.
Symptomatic Management
All patients with symptomatic COVID-19 should be offered symptom management with over-the-counter antipyretics, analgesics, or antitussives for fever, headache, myalgias, and cough.
For Healthcare Providers
- Clinical Decision Aid for COVID-19 Outpatient Therapeutics
- Side-by-Side Overview of Outpatient Therapeutics
- NIH Treatment Guidelines for Non-Hospitalized Adults
- FDA List of Current COVID-19 Emergency Use Authorization Products
- Outpatient COVID-19 Therapeutics Administration Guide
- COVID-19 Therapeutics Locator
- Clinical Considerations for Children and Adults with Confirmed COVID-19
For Patients