Major Update to COVID-19 Treatment Guidelines Released

August 09, 2022

The COVID-19 Treatment Guidelines Panel (the Panel) has published an extensive update to the Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Updates and changes include:

• A new section entitled Special Considerations in People Who Are Immunocompromised. This section covers methods of preventing SARS-CoV-2 infection and discusses key considerations for clinicians managing patients with COVID-19 who are immunocompromised.

• Three new sections that focus on the therapeutic management of COVID-19 in children: Pediatric Clinical Management Summary, Therapeutic Management of Nonhospitalized Children With COVID-19, and Therapeutic Management of Hospitalized Children With COVID-19.

• Special Considerations in Children was revised to include recent epidemiologic data on COVID-19 and information on the risk factors for severe COVID-19 in children.

• The Panel updated Prevention of SARS-CoV-2 Infection to include 2 new revisions to the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for tixagevimab plus cilgavimab (Evusheld), including a warning about the potential risk of cross-hypersensitivity between COVID-19 vaccines and Evusheld and a new recommendation for repeat dosing of tixagevimab 300 mg plus cilgavimab 300 mg every 6 months, as authorized by the updated EUA.

• Therapeutic Management of Nonhospitalized Adults With COVID-19 briefly discusses the recent case reports of viral rebound, with or without recurrence of symptoms, after a course of ritonavir-boosted nirmatrelvir (Paxlovid) has been completed. This section also reviews recent observational data showing that corticosteroids confer no benefits and may potentially cause harm in patients with COVID-19 who do not require supplemental oxygen.

• An update to Kinase Inhibitors: Janus Kinase Inhibitors and Bruton’s Tyrosine Kinase Inhibitors references the recent approval of baricitinib by the FDA for the treatment of COVID-19 in hospitalized adults who require supplemental oxygen, noninvasive ventilation, mechanical ventilation, or extracorporeal membrane oxygenation. A new clinical data table summarizes the results of key randomized controlled trials.

For more information on these updates, please see What's New in the Guidelines on the COVID-19 Treatment Guidelines website.