Recommendations about drugs for COVID-19

National Guidelines on Clinical management of COVID-19, 10e (9 Feb 2022)

Tocilizumab: IL-6 receptor inhibitor - monoclonal antibody

Or,
Baricitinib: Janus Kinase (JAK) inhibitor

Antivirals:
● Paxlovid:
○ Nirmatrelvir - reduces replication by binding to a protease
○ Ritonavir - slows the breakdown of Nirmatrelvir

● Sotrovimab:
binds to spike protein - monoclonal antibody

● Remdesivir:
RNA-dependent RNA polymerase inhibitor

● Molnupiravir:
inhibits mutation by causing error in RNA genome

Antibiotics:
No role of antibiotics unless bacterial co-infection is suspected. If co-infection is suspected:
Moderate cases:
Oral Amoxicillin + Clavulanic Acid or Doxycycline
Severe cases:
IV broad-spectrum antibiotics
 Recommendations for therapeutics
Therapeutics and COVID-19
LIVING GUIDELINE
3 MARCH 2022

Molnupiravir
For patients with non-severe COVID-19 (excluding
pregnant and breastfeeding women, and children)
Conditional recommendation

We suggest treatment with molnupiravir, conditional to those at highest risk of hospitalization

(conditional recommendation for).

Baricitinib, for patients with severe or critical

COVID-19
Strong recommendation for

We recommend treatment with baricitinib (strong recommendation for).

Ruxolitinib and tofacitinib, for patients with severe or

critical COVID-19
Conditional recommendation against

We suggest not to use ruxolitinib or tofacitinib (conditional recommendation against).

Sotrovimab
For patients with non-severe COVID-19
Conditional recommendation

We suggest treatment with sotrovimab, conditional to those at highest risk of hospitalization

(conditional recommendation for).

Convalescent plasma
For patients with non-severe COVID-19
Recommendation against

We recommend against treatment with convalescent plasma (strong recommendation against).

For patients with severe or critical COVID-19

Only in research settings

We recommend not to use convalescent plasma for treatment of COVID-19, except in the context of
a clinical trial (recommended only in research settings).
Casirivimab-imdevimab
(neutralizing monoclonal
antibodies)
For patients with non-severe COVID-19
Conditional recommendation

We suggest treatment with casirivimab-imdevimab, conditional to those at highest risk of

hospitalization, and where viral genotyping can confirm a susceptible SARS-CoV-2 variant (i.e.
excluding Omicron BA1) (conditional recommendation for).

For patients with severe or critical COVID-19

Conditional recommendation

We suggest treatment with casirivimab-imdevimab, conditional to those with seronegative status,

and where viral genotyping can confirm a susceptible SARS-CoV-2 variant (i.e. excluding omicron
BA1) (conditional recommendation for).

IL-6 receptor blockers

For patients with severe or critical COVID-19
Strong recommendation for

We recommend treatment with IL-6 receptor blockers (tocilizumab or sarilumab) (strong

recommendation for).
Ivermectin
For patients with COVID-19, regardless of disease
severity
Only in research settings

We recommend not to use ivermectin, except in the context of a clinical trial (recommended only in
research settings).

Hydroxychloroquine
For patients with COVID-19, regardless of disease
severity
Recommendation against

We recommend not to use hydroxychloroquine or chloroquine (strong recommendation against).

Lopinavir/ritonavir
For patients with COVID-19, regardless of disease
severity
Recommendation against
We recommend not to use lopinavir/ritonavir (strong recommendation against).

Remdesivir
For patients with COVID-19, regardless of disease
severity
Conditional recommendation against

We suggest not to use remdesivir (conditional recommendation against).

Systemic corticosteroids
For patients with severe or critical COVID-19
Strong recommendation for

We recommend treatment with systemic corticosteroids (strong recommendation for).

For patients with non-severe COVID-19 infection

Conditional recommendation against

We suggest not to use systemic corticosteroids (conditional recommendation against).