In the absence of evidence-based guidelines, clinicians in urgent care and other settings have been relying largely on their own clinical experience in caring for patients with COVID-19. That’s about to change, though, as the National Institutes of Health has released guidelines drawn from published and preliminary data and the advice of a panel of physicians, statisticians, and public health experts. It’s important to note amid speculation that certain drugs and nondrug agents “could be” possible cures for the virus, that the NIH guidelines report no drug has been proven to be safe and effective for treating patients with COVID-19. Having said that, the summary recommendations advise against the following:
- Use of hydroxychloroquine plus azithromycin, due to the potential for toxicities
- Use of lopinavir/ritonavir or other HIV protease inhibitors because of unfavorable pharmacodynamics and negative clinical trial data
- Use of ACE inhibitors or ARBs for treatment of COVID-19, though patients already taking these medications for indicated conditions should continue taking them
- Use of systemic corticosteroids for treatment of mechanically ventilated patients with COVID-19 without acute respiratory distress syndrome
The panel found insufficient clinical data to recommend for or against use of convalescent plasma or hyperimmune immunoglobulin for the treatment of COVID-19. NIH plans to update the guidelines as new information comes to light.