NIH Releases Major Update to the COVID-19 Treatment Guidelines

December 01, 2022

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

Key updates to the Guidelines include:

• The Panel added a new section on the antidiabetic agent Metformin, recommending against the use of metformin for the treatment of COVID-19 in nonhospitalized patients and hospitalized patients, except in a clinical trial.
• The evidence rating scheme in Guidelines Development has been revised.
• In Overview of COVID-19, the Panel highlights recent studies that have shown that some racial and ethnic minority groups experience higher rates of COVID-19, subsequent hospitalization, and death in relation to their share of the total U.S. population. The Panel recommends that health care providers, health care systems, and payers ensure equitable access to high-quality care and treatment for all patients, regardless of race, ethnic identity, or other minoritized identity or social status.
• Prevention of SARS-CoV-2 Infection was updated to include information on the new bivalent COVID-19 vaccines. In addition, because tixagevimab plus cilgavimab (Evusheld) is the only product authorized for use as SARS-CoV-2 pre-exposure prophylaxis (PrEP), the Panel continues to recommend the use of this combination as PrEP for eligible individuals despite the increasing prevalence of Omicron subvariants that are resistant to tixagevimab plus cilgavimab.
• The Panel recommends remdesivir as the preferred treatment option for patients who cannot take ritonavir-boosted nirmatrelvir (Paxlovid) because of significant drug-drug interactions. The Panel updated Prioritization of Anti-SARS-CoV-2 Therapies for the Treatment of COVID-19 in Nonhospitalized Patients When There Are Logistical Constraints.
• In COVID-19 Convalescent Plasma, the Panel revised the recommendation for the use of COVID-19 convalescent plasma (CCP) in patients who are immunocompromised.

For a full list of updates, see What's New in the Guidelines on the COVID-19 Treatment Guidelines website.