Mild-moderate symptoms (no supplemental oxygen requirements)
Symptom management
The use of dexamethasone is contradicted
Patients at high risk of severe COVID-19 (e.g., elderly, immunocompromised, > 6 months since vaccinated)
Ritonavir-boosted nirmatrelvira,b
Remdesivirb
Inpatients
No supplemental oxygen
Dexamethasone not indicated
Prophylactic dose of heparin (anticoagulant)
High risk of severe COVID-19
Remdesivirc
Immunocompromised undergoing
Remdesivirc
a) Conventional oxygen supplementation
Require minimal conventional oxygen
Remdesivir
Prophylactic dose of heparin
Most patients (combined therapy)
Remdesivir + dexamethasone
Heparin
Patients receiving dexamethasone with respiratory distress and systemic inflammation
+ Immunomodulator (e.g., baricitinib)
b) HFNC oxygen, NIV, MV, or ECMO
All patientsd
Dexamethasone
Immunomodulator (e.g., baricitinib)
Heparin
COVID-19: coronavirus disease 2019; HFNC: high-flow nasal cannula; NIV: noninvasive ventilation; MV: mechanical ventilation; ECMO: extracorporeal membrane oxygenation. a Recommended 5-day treatment; b treatment therapy to be initiated immediately within 5–7 days of COVID-19 symptomology; c to be administered within 10 days of symptom onset; d add on remdesivir in the immunosuppressed or evidence of ongoing viral replication. +: add on medication
MMP: Conceptualization, Investigation, Writing—original draft. CK: Writing—review & editing, Supervision. Both authors have read and approved the submitted version.
Conflicts of interest
The authors declare that they have no conflicts of interest.
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