NIH Releases New Version of the COVID-19 Treatment Guidelines

March 08, 2023

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

The prevalence of SARS-CoV-2 Omicron subvariants in the U.S. that are not susceptible to tixagevimab plus cilgavimab (Evusheld) is now more than 90%. Hence, the Panel recommends against the use of tixagevimab plus cilgavimab as COVID-19 PrEP. Several sections of the Guidelines have been revised to reflect this recommendation, including Testing for SARS-CoV-2 Infection, Prevention of SARS-CoV-2 Infection, and many of the sections in Special Populations.

Other sections of the guidelines have also been updated:

• The Panel updated the information on breakthrough infection in Clinical Spectrum of SARS-CoV-2 Infection and expanded the description of viral or symptom rebound after COVID-19 and prolonged viral shedding with or without symptoms in patients who are immunocompromised and who have COVID-19.
• Data from 2 case series that describe clinical experience with ritonavir-boosted nirmatrelvir in pregnant patients with COVID-19 has been added to Ritonavir-Boosted Nirmatrelvir (Paxlovid).
• The Ivermectin section now includes data from 3 large randomized controlled trials. These trials reported that the use of ivermectin did not provide a clinical benefit for patients with mild to moderate COVID-19. Based on these results and data from other studies previously reviewed by the Panel, the Panel recommends against the use of ivermectin for the treatment of COVID-19.

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