Table 2.
Treatment of patients with SARS-CoV-2 infection.
| Therapy | Non-hospitalised WHO 1-3 |
Hospitalised w/o oxygen demand WHO 4 |
Low-flow oxygen demand WHO 5 |
High-flow oxygen or NIV/CPAP WHO 6 |
Invasive ventilation, ECMO WHO 7-9 |
|---|---|---|---|---|---|
| Antivirals∗ | Indicated (strong recommendation)∗ | Indicated (weak recommendation)∗ | Inconclusive (data lacking)∗∗∗ | Inconclusive (data lacking)∗∗∗ | Not indicated |
| mAbs∗∗ | Indicated (weak recommendation)∗∗ | Indicated (strong recommendation)∗∗ | Inconclusive (data lacking) | Not indicated | Not indicated |
| Dexamethasone | Not indicated | Not indicated | Indicated (strong recommendation) | Indicated (strong recommendation) | Indicated (strong recommendation) |
| JAKI∗∗∗ | Not indicated | Not indicated | Indicated (strong recommendation)∗∗∗ | Indicated (weak recommendation)∗∗∗ | Indicated (weak recommendation)∗∗∗ |
| Anti-IL6∗∗∗ | Not indicated | Not indicated | Not indicated | Indicated (strong recommendation)∗∗∗ | Continuation if initialed at WHO 6 |
CPAP, continuous positive airway pressure; ECMO, extracorporeal membrane oxygenation; IL-6, interleukin-6; JAKIs, Janus kinase inhibitors; mAbs, monoclonal antibodies; NIV, non-invasive ventilation; WHO, World Health Organization.
Indicated in high-risk patients (lack of immune protection, especially immunosuppression) within 5 days of symptom onset, this includes inpatients with recently diagnosed nosocomial SARS-CoV-2 infection; whether later administration is appropriate in highly immunosuppressed patients must be decided on a case-by-case basis.
Indicated in high-risk patients when symptom onset was ≤7 days ago or when SARS-CoV-2 detection was ≤3 days ago and when there are no or only mild symptoms. This includes inpatients with recently diagnosed nosocomial SARS-CoV-2 infection. The use of mAbs requires a negative antibody test, which, however, can be omitted in highly immunosuppressed patients.
In combination with dexamethasone.