The most recent updates to the WHO guidelines for Covid-19 treatment take into account the virulence and transmissibility of current circulating SARS-CoV-2 viral strains. — Freepik
A panel of international experts representing the World Health Organization’s (WHO) Guideline Development Group has updated its guidance on treatments for patients with Covid-19.
The new recommendations published by The BMJ are part of a living guideline, developed by the WHO with the methodological support of MAGIC Evidence Ecosystem Foundation, to provide up-to-date, trustworthy guidance on the management of Covid-19 and help doctors make better decisions with their patients.
The guidance incorporates the latest clinical trial evidence for existing and new Covid-19 therapies and takes account of evidence relating to safety, prognosis, resources, access and equity issues, as well as patient values and preferences.
The updates include:
- Distinct risk categories to help doctors more accurately assess whether an individual is at high, moderate or low risk of hospital admission and tailor treatment accordingly.
- A new treatment benefit threshold of 1.5% (down from 6%) reduction in the risk of hospital admission.
This reflects the lower baseline risk for most patients with non-severe Covid-19, as well as more safety evidence and wider availability of therapies.
- A recommendation to use the antiviral drug nirmatrelvir-ritonavir in patients with non-severe Covid-19 at high and moderate risk of hospital admission.
- A recommendation against use of the antiviral drugs remdesivir and molnupiravir for patients with non-severe Covid-19 at moderate and low risk of hospital admission (treatment is suggested for patients at high risk of admission).
- A recommendation against use of a new antiviral (VV116) for patients with Covid-19, except in clinical trials, regardless of illness severity.
- A strong recommendation against the use of ivermectin for patients with non-severe Covid-19 (advice against use of ivermectin in patients with severe or critical Covid-19, except in clinical trials, still exists).
The experts say the new recommendations reflect changes in the virulence and transmissibility of circulating SARS-CoV-2 viral variants and sub-variants, along with changes in immunity related to global vaccinations, which have led to lower baseline risks of severe illness and death for most patients with non-severe Covid-19.
They acknowledge that there are still uncertainties around Covid-19 therapeutics and emerging evidence, and say these recommendations need to be used in light of these uncertainties.
An interactive decision support tool is available to accompany this guidance.
Editor's note: This information is accurate at the time of publication. As new data and evidence is still emerging about Covid-19, please ensure you are accessing the latest information available at the time of reading.
