Therapeutics and COVID-19: living guideline

Overview

The WHO Therapeutics and COVID-19: living guideline contains the Organization’s most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges.

This sixth version of the WHO guideline now contains nine recommendations, including two new recommendations regarding the use of a combination of neutralizing monoclonal antibodies, casirivimab and imdevimab. No further updates to the previous existing recommendations were made in this latest version. 

The WHO Therapeutics and COVID-19: living guideline currently includes a:

• ** NEW ** conditional recommendation to use a combination of neutralizing monoclonal antibodies (casirivimab and imdevimab) in non-severe COVID-19 patients at the highest risk of severe disease (published 24 September 2021);
• ** NEW ** conditional recommendation to use a combination of neutralizing monoclonal antibodies (casirivimab and imdevimab) in severe and critically ill COVID-19 patients with seronegative status (published 24 September 2021);
• strong recommendation to use IL-6 receptor blockers (tocilizumab or sarilumab) in patients with severe or critical COVID-19 (published 6 July 2021);
• recommendation not to use ivermectin in patients with COVID-19 except in the context of a clinical trial (published 31 March 2021);
• strong recommendation against hydroxychloroquine in patients with COVID-19 of any severity (published 17 December 2020);
• strong recommendation against lopinavir/ritonavir in patients with COVID-19 of any severity (published 17 December 2020);
• conditional recommendation against remdesivir in hospitalized patients with COVID-19 (published 20 November 2020);
• strong recommendation for systemic corticosteroids in patients with severe and critical COVID-19 (published 2 September 2020);
• conditional recommendation against systemic corticosteroids in patients with non-severe COVID-19 (published 2 September 2020).

Other COVID-19 therapeutics that are currently under consideration by WHO include convalescent plasma, colchicine and anticoagulants. This guideline will be updated if/when sufficient new evidence warrants this. 

Guidelines regarding the use of drugs to prevent (rather than treat) COVID-19 are included in a separate document, WHO Living guideline: Drugs to prevent COVID-19, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).

Guidelines regarding the clinical management of COVID-19 patients are included in a further document, COVID-19 Clinical management: Living guideline, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).

To view previous (now outdated) versions of this guideline, please see the links below:

• First version, published 2 September 2020 (accessible as pdf only)
• Second version, published 20 November 2020 (access as pdf or via online platform)
• Third version, published 17 December 2020 (access as pdf or via online platform)
• Fourth version, published 31 March 2021 (access as pdf or via online platform)
• Fifth version, published 6 July 2021 (access as pdf or via online platform)

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