Outpatient Treatment of Confirmed COVID-19 in Symptomatic Adults: Living, Rapid Practice Points From the American College of Physicians (Version 3).

DESCRIPTION: The American College of Physicians (ACP) maintains living, rapid practice points on antiviral treatment in the outpatient setting for COVID-19.

METHODS

The Population Health and Medical Science Committee (PHMSC) developed this version 3 based on evidence from a focused update of a living, rapid review conducted by the ACP Center for Evidence Reviews at Cochrane Austria. This version addresses the SARS-CoV-2 Omicron variant and reaffirms previous practice points on the use of antiviral treatments of confirmed COVID-19 in unvaccinated or vaccinated and symptomatic patients in the outpatient setting.

PRACTICE POINT 1: Consider nirmatrelvir-ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 2: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.

PRACTICE POINT 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

PRACTICE POINT 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.

RETIREMENT FROM LIVING STATUS: The PHMSC is retiring this topic from living status considering that this update and previous surveillance have not yielded important changes to the practice points.