ASHP-COVID-19-Evidence-Table 2020

Assessment of Evidence for COVID-19-Related Treatments: Updated 5/6/2020
The information contained in this evidence table is emerging and rapidly evolving because of ongoing research and is subject to the profes-
i al j dg e a d i e e a i f he ac i i e d e he i e e f each edical facili a ach he ca e of patients with
COVID-19 and the needs of individual patients. ASHP provides this evidence table to help practitioners better understand current approaches
related to treatment and care. ASHP has made reasonable efforts to ensure the accuracy and appropriateness of the information presented.
However, any reader of this information is advised ASHP is not responsible for the continued currency of the information, for any errors or
omissions, and/or for any consequences arising from the use of the information in the evidence table in any and all practice settings. Any
reader of this document is cautioned that ASHP makes no representation, guarantee, or warranty, express or implied, as to the accuracy and
appropriateness of the information contained in this evidence table and will bear no responsibility or liability for the results or consequences
of its use. Public access to AHFS Drug Information® (https://www.ahfscdi.com/login) is available for the next 60 days with the username
"[email protected]" and password "covid-19." ASHP's patient medication information is available at http://www.safemedication.com/.
Select entries were updated on 5/6/2020; these can be identified by the date that appears in the Drug(s) column.
TABLE OF CONTENTS
ANTIVIRAL AGENTS SUPPORTING AGENTS OTHER

BALOXAVIR ANAKINRA ACE INHIBITORS ANGIOTENSIN II
CHLOROQUINE PHOSPHATE ASCORBIC ACID RECEPTOR BLOCKERS ARBs
FAVIPIRAVIR ANTICOAGULANTS
AZITHROMYCIN
A igan Fa ila ir lo molec lar eight heparin LMWH
BARICITINIB Ol miant nfractionated heparin UFH
HIV PROTEASE INHIBITORS
COLCHICINE FAMOTIDINE
e g LPV RTV Kaletra
CORTICOSTEROIDS general HMG-CoA REDUCTASE INHIBITORS
HYDROXYCHLOROQUINE statins
Plaq enil COVID- CONVALESCENT PLASMA
IMMUNE GLOBULIN
NEURAMINIDASE INHIBITORS EPOPROSTENOL inhaled IGIV IVIG γ-glob lin
e g oseltami ir METHYLPREDNISOLONE IVERMECTIN
REMDESIVIR DEPO-Medrol SOLU-Medrol
NEBULIZED DRUGS
UMIFENOVIR Arbidol NITRIC OXIDE inhaled
NICLOSAMIDE
RUXOLITINIB Jakafi NITAZOXANIDE
SARILUMAB Kef ara NONSTEROIDAL ANTI-INFLAMMATORY
SIROLIMUS Rapam ne AGENTS NSAIAs
TOCILIZUMAB Actemra TISSUE PLASMINOGEN ACTIVATOR
t-PA alteplase
Updated 5-06-20. The current version of this document can be found on the ASHP COVID-19 Resource Center. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
ANTIVIRAL AGENTS
Drug(s) AHFS Class Rationale Trials or Clinical Experience Dosagea Comments
Balo a ir Anti iral acti e against C rrentl no kno n p blished clinical trial Protocol in one registered Chinese No data to date s pport se in the
Anti iral infl en a ir ses data regarding efficac or safet in the trial specifies a balo a treatment of COVID-
treatment of COVID- ir marbo il dosage of mg orall
on da mg orall on da and
China T o randomi ed clinical trials regis mg orall on da as needed not
tered b t not et recr iting to e ceed total doses
Chinese Clinical Trial Registr links
ChiCTR
CHiCTR
Chloroq ine In itro acti it against Only limited clinical trial data available to Optimal dosage and duration of Efficac and safet of chloroq ine for
Phosphate Antimalarial ario s ir ses incl ding date to e al ate se of chloroq ine for treatment not known , treatment or pre ention of COVID-
corona ir ses - treatment or pre ention of COVID- not established
Updated Consider: mg of chloroq ine
In itro acti it against Clinical experience in treating pts ith phosphate is eq i alent to mg of Additional data needed to determine
SARS-CoV- in infected COVID- acc m lating reports of possi chloroq ine base hether in itro acti it against SARS-
Vero E cells reported ble clinical benefits incl ding decrease in CoV- corresponds ith clinical efficac
some e idence it ma block iral load and d ration of illness onl lim Various dosages recommended or for treatment or pre ention of COVID-
infection in Vero E cells ited data a ailable to date to s pport effi being investigated for treatment of
e posed to SARS-CoV- cac and identif possible safet concerns COVID-
-
in pts ith COVID- Additional data needed to s bstantiate
Oral chloroquine phosphate dosage initial reports of efficac for treatment
Acti e in itro against SARS- Double-blind randomized phase b study suggested in the EUA: For treatment and identif optimal dose and d ration
CoV- and MERS-CoV in Brazil (Borba et al) to e al ate t o of hospitali ed ad lts and adoles
different chloroq ine dosages as adj nc cents eighing kg or more hen a Additional data needed regarding to ici
Has imm nomod lator ti e therap in hospitali ed ad lts ith clinical trial is not a ailable or partici t profile hen sed in patients ith
acti it that theoreticall se ere COVID- NCT The first pation not feasible g on da COVID-
co ld contrib te to an anti- enrolled pts ere randomi ed to then mg dail for - da s of
inflammator response in recei e high-dose chloroq ine mg total treatment based on clinical Chloroq ine s ggested as possible op
patients ith iral infec t ice dail for da s or lo er-dose chlo e al ation tion and incl ded in Chinese g idelines
tions - -
roq ine mg t ice dail on da then for treatment of COVID-
mg once dail on da s - all pts also Oral chloroquine phosphate: mg
Kno n pharmacokinetics recei ed a ithrom cin and ceftria one and t ice dail for da s ad lts - NIH COVID- Treatment G idelines
and to icit profile some also recei ed oseltami ir An n ears eighing kg mg t ice Panel states that clinical data are ins ffi
planned interim anal sis as performed dail on da s and then mg cient to recommend either for or
and the high-dose arm of the st d as once dail on da s - ad lts eigh against the se of chloroq ine for the
halted beca se of to icit concerns partic ing kg treatment of COVID-
larl QTc prolongation and entric lar
tach cardia and beca se more deaths Oral chloroquine phosphate Initial IDSA recommends that chloroq ine be
ere reported in this arm B da dose of mg of chloroq ine sed for the treatment of COVID- in
pts treated ith the high-dose follo ed b mg of chloroq ine the conte t of a clinical trial
regimen had died s treated ho rs later on da then mg
ith the lo er-dose regimen QTc of chloroq ine t ice dail on da s NIH COVID- Treatment G idelines
msec occ rred more freq entl in the high - Panel does not recommend the se of
-dose gro p than in the lo er- an agents incl ding chloroq ine for
dose gro p The high-dose arm
incl ded more pts prone to cardiac compli pree pos re proph la is PrEP or post
cations than the lo er-dose arm Data e pos re proph la is PEP for pre en
ere ins fficient to e al ate efficac St d tion of SARS-CoV- infection o tside of
contin ing sing onl the lo er dosage clinical trials
M ltiple clinical trials to e al ate chloro Beca se chloroq ine is associated ith
q ine for the treatment of COVID- are QT prolongation ca tion is ad ised in
registered at clinicaltrials go some listed pts at risk for QT prolongation or recei
belo ing other dr gs associated ith arrh th
NCT mias diagnostic testing and moni
NCT toring recommended to minimi e risk of
NCT ad erse effects incl ding dr g-ind ced
NCT cardiac effects
NCT
NCT FDA iss ed a safet alert regarding ad
NCT erse cardiac effects e g prolonged QT
inter al entric lar tach cardia en
Se eral clinical trials to e al ate chloro tric lar fibrillation reported ith se of
q ine for pre ention of COVID- in the chloroq ine or h dro chloroq ine
healthcare setting are registered at clinical either alone or in conj nction ith
trials go a ithrom cin or other dr gs kno n to
NCT prolong QT inter al in hospital and
NCT o tpatient settings FDA ca tions
NCT against se of chloroq ine or h
dro chloroq ine o tside of a clinical
trial or hospital setting and rges
healthcare professionals and pts to
report ad erse effects in ol ing these
dr gs to FDA MedWatch
Emergency use authorization (EUA) for

chloroquine: FDA iss ed an EUA that
permits distrib tion of the dr g from
the strategic national stockpile SNS for
se only in ad lts and adolescents
eighing kg or more hospitali ed
ith COVID- for hom a clinical trial
is not a ailable or participation not fea
sible To req est the dr g
healthcare pro iders sho ld contact
local or state health departments
distrib tion to states ill be managed
b the Office of the Assistant Secretar
for Preparedness and Response ASPR
and FEMA To mitigate risks of this
nappro ed se the EUA incl des cer
tain mandator req irements incl ding
ad erse e ent reporting to FDA Med
Watch FDA states that based on
the totalit of scientific e idence a aila
ble it is reasonable to belie e that the
dr g ma be effecti e in treating COVID-
and that hen sed nder the EUA
conditions kno n and potential bene
fits o t eigh kno n and potential risks
Cons lt the EUA EUA fact sheet for
healthcare pro iders and EUA fact
sheet for patients and parent caregi ers
for additional information
Fa ipira ir Broad-spectr m anti iral Only very limited clinical trial data availa- A fa ipira ir dosage of mg t ice Not commerciall a ailable in the US
A igan Anti iral ith in itro acti it ble to date to e al ate se of fa ipira ir in dail on da then mg t ice
Fa ila ir against ario s ir ses the treatment of COVID- dail thereafter for 10 da s as Efficac and safet of fa ipira ir for
incl ding corona ir ses 1 5
sed in one open-label COVID- treatment of COVID- not established
Updated Open-label, prospective, randomized, st d
In itro e idence of acti it multicenter study in ad lts ith Additional data needed to s bstantiate
against SARS-CoV- in in COVID- pne monia in China A fa ipira ir dosage of mg t ice initial reports of efficac for treatment
fected Vero E cells report ChiCTR Fa ipira ir mg dail on da then mg t ice of COVID- and identif optimal dose
ed ith high concentra orall t ice dail on da then mg dail thereafter for da s as sed and d ration
tions of the dr g orall t ice dail thereafter for 10 da s in one open-label COVID- st d
as associated ith greater clinical reco Earl embr onic deaths and teratogen
Licensed in Japan and Chi er rate at da s s compared Protocol in one ongoing trial icit obser ed in animal st dies Fa ipi
na for treatment of infl ith the control gro p treated ith NCT for treatment of ra ir is contraindicated in omen ith
en a mifeno ir Arbidol mg times dail moderate COVID- specifies a fa i kno n or s spected pregnanc and
for 10 da s Stratified b disease se eri pira ir dosage of mg t ice dail preca tions sho ld be taken to a oid
t clinical reco er rate at da in pts ith on da then mg three times pregnanc d ring treatment ith the
moderate COVID- pne monia as in dail thereafter for p to da s dr g
the fa ipira ir gro p s in the
mifeno ir gro p clinical reco er rate in Protocol in one ongoing trial If fa ipira ir is sed in pts recei ing ac
those ith se ere COVID- pne monia NCT for treatment of mild etaminophen the ma im m recom
as s respecti el T ice as man COVID- specifies a fa ipira ir dos mended dail dosage of acetaminophen
pts in the fa ipira ir gro p had se ere dis age of mg on da then is g
ease compared ith the gro p recei ing mg t ice dail on da s 2 10
mifeno ir
Protocol in one ongoing trial
In a small, open-label, nonrandomized NCT for treatment of non
study in patients ith non-se ere COVID- -se ere COVID- specifies a fa ipi
in China ChiCTR fa ipi ra ir dosage of mg e er
ra ir mg orall t ice dail on da ho rs on da then mg e er
then mg orall t ice dail on da s 2 ho rs on da s 2 10
n as associated ith decreased
median time to iral clearance s Protocol in one ongoing trial
da s and higher impro ement rate on NCT for treatment of
chest CT imaging on da s COVID- specifies a fa ipira ir dos
compared ith the control gro p recei ing age of mg t ice dail on da
lopina ir ritona ir n both gro ps also then mg t ice dail on da s 2
recei ed aerosoli ed interferon α-1b
Italy: Randomi ed placebo-controlled Beca se high fa ipira ir concentra

m lticenter trial NCT to e al tions are req ired for in itro acti it
ate efficac and safet of fa ipira ir in pts against SARS-CoV- it has been
ith moderate COVID- started s ggested that high fa ipira ir dosag
estimated completion date es like those sed in the treatment
of Ebola ir s disease sho ld be
US Randomi ed controlled open-label considered for the treatment of
proof-of-concept trial NCT of COVID- One s ch fa ipira ir
fa ipira ir for the treatment of COVID- regimen sed in the treatment of
Ebola ir s disease incl des a loading
dosage of mg doses of
US Randomi ed open-label trial mg mg and mg gi en
NCT to e al ate efficac of fa i ho rs apart on da then a mainte
pira ir in pts ith mild ncomplicated nance dosage of mg e er
COVID- ho rs on da s 2 10.
Multiple clinical trials initiated in pts ith

COVID- in China Japan and other co n
tries to e al ate fa ipira ir alone or in con
j nction ith other anti irals or other
agents -
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
ChiCTR
ChiCTR
ChiCTR
ChiCTR
ChiCTR
ChiCTR
JapicCTI-
JPRN-jRCTs
JPRN-jRCTs
HIV Protease Lopinavir (LPV): In itro Lopinavir and Ritonavir (LPV/RTV; Kalet- LPV/RTV (COVID- ): LPV mg LPV/RTV: Efficac for the treatment of
Inhibitors HIV Protease acti it against SARS-CoV- ra®) randomized, open-label trial in China RTV mg orall t ice dail for - COVID- ith or itho t other anti i
Inhibitors in Vero E cells also has in hospitali ed ad lts ith se ere COVID- da s rals not definitel established
Updated in itro acti it against SARS compared LPV RTV in conj nction ith
-CoV- and MERS-CoV standard care pts s standard care LPV/RTV (COVID- ): LPV mg Darunavir: No data to date to s pport
some e idence of benefit in alone pts Primar end point as RTV mg orall t ice dail ith se in the treatment of COVID- Man
animal st dies for treatment time to clinical impro ement time from or itho t mifeno ir Arbidol fact rer states the ha e no clinical or
of MERS-CoV randomi ation to impro ement of t o mg e er ho rs pharmacologic e idence to s pport se
points on a se en-categor ordinal scale or of DRV cobicistat for treatment of
Atazanavir (ATV): ATV hospital discharge hiche er came first LPV/RTV (COVID- ): LPV mg COVID- and initial np blished res lts
alone or ith ritona ir ATV In ITT pop lation time to clinical improve- RTV mg orall t ice dail for no from a st d in China indicated that a -
RTV has in itro acti it ment was not shorter with LPV/RTV com- longer than da s ith or ith da regimen of DRV cobicistat as not
against SARS-CoV- in Vero pared with standard care median time to o t interferon million nits of effecti e for treatment of COVID-
E cells h man epithe clinical impro ement da s in both interferon-α or eq i alent t ice
lial p lmonar cells A gro ps in modified ITT pop lation medi dail gi en in mL of sterile ater Atazanavir, Nelfinavir, Saquinavir,
and h man monoc tes an time to clinical impro ement da s in b neb li ation and ith or itho t Tipranavir: No data to date to s pport
LPV RTV gro p and da s in standard riba irin for p to da s se in the treatment of COVID-
Darunavir (DRV): In one care onl gro p The -da mortalit rate
st d DRV ith cobicistat as n mericall lo er in LPV RTV gro p LPV/RTV (SARS): LPV mg RTV NIH COVID- Treatment G idelines
had no in itro acti it s in ITT pop lation s mg orall t ice dail for da s Panel recommends against the se of
against SARS-CoV- at clini in modified ITT pop lation Some ith riba irin -g oral loading dose LPV RTV or other HIV protease inhibi
call rele ant concentra e idence that LPV RTV initiation ithin then g orall e er ho rs or tors for the treatment of COVID-
tions in Caco- cells in da s after s mptom onset is associated mg kg IV e er ho rs e cept in the conte t of a clinical trial
another st d high DRV ith shorter time to clinical impro ement
concentrations ere re No significant differences in reduction of LPV/RTV (MERS): LPV mg RTV IDSA recommends that LPV RTV be
q ired for in itro inhibition viral RNA load, duration of viral RNA de- mg orall t ice dail ith riba i sed for the treatment of COVID-
of SARS-CoV- in Vero E tectability, duration of oxygen therapy, rin ario s regimens and or inter onl in the conte t of a clinical trial
cells duration of hospitalization, or time from feron-α ; LPV mg RTV mg
randomization to death. LPV RTV stopped orall t ice dail ith interferon
earl in pts beca se of ad erse effects β1b mg mL s b-Q on alternate
Nelfinavir (NFV), Saquinavir da s for da s
(SQV), and Tipranavir (TPV): LPV/RTV retrospective cohort study in
In itro acti it against SARS China e al ated se of LPV RTV ith or
-CoV- in Vero E cells itho t mifeno ir Arbidol in ad lts
Primar end point as negati e con ersion
in nasophar ngeal samples and progres
sion or impro ement of pne monia At
da s SARS-CoV- ndetectable in naso
phar ngeal specimens in pts
treated ith LPV RTV alone s
treated ith both dr gs chest CT scans
ere impro ing in of pts treated ith
LPV RTV alone s of pts treated ith
both dr gs See Umifeno ir in this E i
dence Table
LPV/RTV Clinical Experience (COVID- ):

Onl limited data on LPV RTV sed ith
or itho t interferon in pts ith COVID-
o tside of clinical trials
LPV/RTV Clinical Experience (SARS and

MERS): E idence of some clinical benefit
hen sed in conj nction ith riba irin
and or interferon
LPV/RTV COVID- Clinical Trials at clini-

caltrials.gov:
NCT LPV RTV s h dro chloro
q ine in pts ith mild disease
NCT LPV RTV ith riba irin and
interferon β-1b s LPV RTV alone
NCT LPV RTV s h dro chloro
q ine s losartan s placebo
Darunavir COVID- Clinical Trials:

NCT Open-label randomi ed trial
in China to e al ate DRV cobicistat
NTC Open-label randomi ed trial
in Thailand to e al ate DRV RTV in con
j nction ith other anti irals
ChiCTR Open-label random
i ed trial in China to e al ate DRV
cobicistat s LPV RTV
H dro chlo In itro acti it against Only limited clinical trial data available to Optimal dosage and duration of Efficac and safet of h dro chloro
roq ine Antimalarial ario s ir ses incl ding date to e al ate se of h dro chloroq ine treatment not known , q ine for treatment or pre ention of
-
Plaq enil corona ir ses for treatment or pre ention of COVID- COVID- not established
Various dosages recommended or
Updated In itro acti it against Clinical experience in treating pts ith being investigated for treatment of Additional data needed to determine
SARS-CoV- in infected COVID- acc m lating onl limited data COVID- hether in itro acti it against SARS-
Vero E cells reported a ailable to date to s pport efficac and CoV- corresponds ith clinical efficac
ma be more potent than identif possible safet concerns in pts ith Oral hydroxychloroquine sulfate for treatment or pre ention of COVID-
chloroq ine in itro b t COVID- dosage suggested in the EUA: For
some data are conflicting treatment of hospitali ed ad lts and
and additional st d need Hydroxychloroquine small pilot study con- adolescents eighing kg or more Additional data needed to s bstantiate
ed ducted in China: treatment-nai e pts hen a clinical trial is not a ailable or initial reports of efficac for treatment
recei ed h dro chloroq ine s lfate participation not feasible mg on and identif optimal dose and d ration
Has imm nomod lator mg dail for da s ith con entional da then mg dail for - da s
acti it that theoreticall treatments and pts recei ed con ention of total treatment based on clinical Additional data needed before an con
co ld contrib te to an anti- al treatments alone both groups re- e al ation cl sions can be made regarding possible
inflammator response in ceived interferon and most pts also re- benefits and safet of sing h
patients ith iral infec ceived umifenovir (Arbidol®) or LPV/RTV Oral hydroxychloroquine sulfate: dro chloroq ine ith a ithrom cin
tions Primar end point as con ersion to mg t ice dail on da then See A ithrom cin in this E idence Ta
negati e PCR in phar ngeal s abs on da mg t ice dail on da s - ble
Kno n pharmacokinetics Negati e PCR reported at da in pts
and to icit profile treated ith h dro chloroq ine
H dro l analog of chloro and pts not treated ith the Oral hydroxychloroquine sulfate: Additional data needed regarding to ici
q ine ith similar mecha dr g data nclear for pts median d ra mg once or t ice dail for - t profile hen sed in patients ith
nisms of action and ad tion from hospitali ation to negati e con da s COVID-
erse effects ma ersion and to temperat re normali ation
ha e more fa orable dose- ere similar in both gro ps e idence of Oral hydroxychloroquine sulfate: H dro chloroq ine s ggested as possi
related to icit profile than radiologic progression on CT in pts treat mg t ice dail on da then ble option and incl ded in Chinese
chloroq ine - b t cardi ed ith the dr g and pts not treated ith mg dail on da s - g idelines for treatment of COVID-
oto icit e g prolonged the dr g all pts sho ed impro ement at
QT inter al is a concern follo - p Oral hydroxychloroquine sulfate: NIH COVID- Treatment G idelines
ith both dr gs - mg t ice dail for - da s Panel states that clinical data are ins ffi
Hydroxychloroquine randomized, parallel- cient to recommend either for or
group study in adults in China against se of h dro chloroq ine for
(ChiCTR ): pts ith COVID- Oral hydroxychloroquine sulfate: the treatment of COVID-
and pne monia recei ed hydroxychloro- mg times dail for da s IDSA recommends that h dro chloro
quine sulfate mg t ice dail for q ine be sed for the treatment of
da s and standard treatment (O , antiviral COVID- in the conte t of a clinical
agents, antibacterial agents, immuno- trial
globulin, with or without corticosteroids)
and other pts recei ed standard treat- NIH COVID- Treatment G idelines
ment alone control gro p E cl sion Panel recommends against the se of a
criteria incl ded se ere and critical illness combined regimen of h dro chloro
Pts assessed at baseline and da s after q ine and a ithrom cin for the treat
treatment initiation for time to clinical re ment of COVID- e cept in the conte t
co er TTCR defined as normali ation of of a clinical trial
fe er and co gh relief maintained for
ho rs clinical characteristics and changes IDSA recommends that a combined
on chest CT It as concl ded that h regimen of h dro chloroq ine and
dro chloroq ine as associated ith a ithrom cin be sed for the treatment
s mptom relief since time to fe er normali of COVID- onl in the conte t of a
ation as shorter in h dro chloroq ine clinical trial
gro p da s s control gro p
da s time to co gh remission as shorter
in h dro chloroq ine gro p and pne mo NIH COVID- Treatment G idelines
nia impro ed in pts in h Panel does not recommend the se of
dro chloroq ine gro p s pts an agents incl ding h dro chloro
in control gro p Total of pts q ine for pree pos re proph la is
progressed to se ere illness all in the con PrEP or poste pos re proph la is
trol gro p Note: This st d did not PEP for pre ention of SARS-CoV-
incl de pts ith se ere disease and pts infection o tside of clinical trials
recei ed other anti-infecti es in addition to Beca se h dro chloroq ine is associat
h dro chloroq ine At st d entr pts ed ith QT prolongation ca tion is
itho t fe er and pts itho t co gh ad ised in pts at risk for QT prolonga
ere incl ded in h dro chloroq ine gro p tion or recei ing other dr gs associated
and pts itho t fe er and pts ith ith arrh thmias diagnostic testing
o t co gh ere incl ded in control gro p and monitoring recommended to mini
nclear ho these pts ere addressed in mi e risk of ad erse effects incl ding
TTCR calc lations Altho gh initial regis dr g-ind ced cardiac effects
tered st d protocol specified different
h dro chloroq ine treatment gro ps and FDA iss ed a safet alert regarding ad
a placebo gro p each ith pts and erse cardiac effects e g prolonged QT
primar end points of time to negati e inter al entric lar tach cardia en
n cleic acid and T-cell reco er data tric lar fibrillation reported ith se of
pro ided onl for certain clinical s mptoms chloroq ine or h dro chloroq ine
in pts itho t se ere disease and PCR either alone or in conj nction ith
res lts not reported a ithrom cin or other dr gs kno n to
prolong QT inter al in hospital and
Hydroxychloroquine with azithromycin o tpatient settings FDA ca tions
open-label, nonrandomized study in against se of chloroq ine or h
France (Gautret et al): Preliminar data dro chloroq ine o tside of a clinical
from an ongoing st d in hospitali ed pts trial or hospital setting and rges
ith confirmed COVID- as sed to as healthcare professionals and pts to
sess efficac of h dro chloroq ine sed report ad erse effects in ol ing these
alone or ith a ithrom cin ntreated pts dr gs to FDA MedWatch
ere sed as a negati e control The prima
r end point as negati e PCR res lts in Emergency use authorization (EUA) for
nasophar ngeal samples at da Data hydroxychloroquine: FDA iss ed an
from pts treated ith h dro chloro EUA that permits distrib tion of the
q ine mg times dail for da s dr g from the strategic national stock
pts treated ith h dro chloroq ine and pile SNS for se only in ad lts and
a ithrom cin mg on da then adolescents eighing kg or more
mg dail on da s - and pts in the hospitali ed ith COVID- for hom a
control gro p ere anal ed At da clinical trial is not a ailable or participa
in the h dro chloroq ine tion not feasible To req est the
gro p in the h dro chloro dr g healthcare pro iders sho ld con
q ine and a ithrom cin gro p and tact local or state health departments
in the control gro p had negati e distrib tion to states ill be managed
PCR res lts At da a positi e PCR as b the Office of the Assistant Secretar
reported in a pt treated ith both dr gs for Preparedness and Response ASPR
ho had tested negati e at da Note: and FEMA To mitigate risks of this
This as a small nonrandomi ed st d that nappro ed se the EUA incl des cer
didn’t appear to be designed to compare tain mandator req irements incl ding
h dro chloroq ine s h dro chloroq ine ad erse e ent reporting to FDA Med
and a ithrom cin pts recei ed antibiotics Watch FDA states that based on
to pre ent bacterial s perinfection based the totalit of scientific e idence a aila
on clinical j dgment Data on disease se ble it is reasonable to belie e that the
erit as nclear some as mptomatic pts dr g ma be effecti e in treating COVID-
ere incl ded hen st d initiated and and that hen sed nder the EUA
information on disease progression and conditions kno n and potential bene
clinical o tcomes as not presented fits o t eigh kno n and potential risks
Cons lt the EUA EUA fact sheet for
Hydroxychloroquine with azithromycin healthcare pro iders and EUA fact
open-label, uncontrolled study in France sheet for patients and parent caregi ers
(Molina et al): ad lts hospitali ed ith for additional information
COVID- recei ed h dro chloroq ine
mg dail for da s and a ithrom cin
mg on da then mg dail on
NCT
da s - At time of treatment initiation
pts had significant comorbidities asso
ciated ith poor o tcomes and had
fe er and recei ed O Within da s pt
died and transferred to ICU the regimen
discontin ed in pt after da s beca se of
prolonged QT inter al Nasophar ngeal
samples ere still PCR positi e at da s
and in pts tested Note: In this
small ncontrolled st d h dro chloro
q ine and a ithrom cin regimen did not
res lt in rapid iral clearance or pro ide
clinical benefit
Hydroxychloroquine with azithromycin

uncontrolled, retrospective, observational
study in France (Gautret et al): ad lts
ith confirmed COVID- incl ding pts
incl ded in a pre io s st d b the same
gro p ere treated ith h dro chloro
q ine mg times dail for da s
and a ithrom cin mg on da then
mg dail on da s - Majorit
ere considered lo risk for clinical deteri
oration lo national earl arning score
for COVID- based on age respirator
rate O sat ration temperat re BP p lse
le el of conscio sness onl had fe er
pts ere as mptomatic carriers mean
time from onset of s mptoms to treatment
initiation as da s Clinical o tcome
contagio sness as assessed b nasophar n
geal PCR assa and c lt re and length of
sta in infectio s disease ID nit ere
e al ated in pts ho ere treated for at
least da s and follo ed for at least
da s Fa orable o tcome as reported for
req ired O pts transferred
to ICU pt died mean time to discharge
from ID nit as da s At da PCR
res lts ere negati e in of those test
ed at da iral c lt res ere negati e in
of those tested Note: Almost all
pts ere considered lo risk for clinical
deterioration incl ding pts described as
as mptomatic carriers and it is nclear
ho man o ld ha e had spontaneo s
con ersion to negati e nasophar ngeal
samples d ring same time frame Altho gh
pts ere enrolled PCR res lts a ailable
for fe er pts beginning on da and onl
pts represented in da data This as
an ncontrolled st d and data presented
cannot be sed to determine hether a
regimen of h dro chloroq ine ith
a ithrom cin pro ides benefits in terms of
disease progression or decreased infec
tio sness especiall for pts ith more se
ere disease
Hydroxychloroquine (with or without

azithromycin) in a retrospective analysis of
patients hospitalized with COVID- in US
Veterans Health Administration medical
centers (Magagnoli et al): Data for
males median age ears treated ith
h dro chloroq ine in addition to standard
s pporti e management ere anal ed for
death rate and need for mechanical entila
tion Death rate as in those
treated ith h dro chloroq ine
in those treated ith h
dro chloroq ine and a ithrom cin and
in those not treated ith
h dro chloroq ine rate of entilation as
and respecti el Use of
h dro chloroq ine alone b t not se of
h dro chloroq ine and a ithrom cin as
associated ith increased o erall mortalit
compared ith no h dro chloroq ine se
of h dro chloroq ine ith or itho t
a ithrom cin did not red ce the risk of
mechanical entilation Note: The pt
pop lation incl ded onl elderl males -
ears of age man ith significant
comorbidities This anal sis did not look at
efficac meas res
Efficacy measures: Initial st dies e al

ating h dro chloroq ine based efficac of
the dr g on negati e con ersion in naso
phar ngeal samples at da or RT-
PCR tests sing pper and lo er respirator
specimens incl ding nasophar ngeal and
orophar ngeal s abs are recommended
for diagnosis of COVID- ho e er
d namics of SARS-Co - in infected pa
tients ntreated or treated and presence
of the ir s at ario s bod sites o er the
co rse of infection ha e not been f ll
determined
M ltiple clinical trials to e al ate h

dro chloroq ine for treatment of COVID-
are registered at clinicaltrials go some
listed belo
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
M ltiple clinical trials to e al ate h

dro chloroq ine for pre ention of COVID-
in the healthcare setting or in ho sehold
contacts of pts ith the disease are regis
tered at clinicaltrials go some listed be
lo
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
NCT
Ne ramini Anti irals acti e against In a retrospective case series of patients Dosage of oseltami ir in the case No data to date s pport se in the
dase inhibi infl en a ir ses ith COVID- at single center in W han series of patients as mg orall treatment of COVID-
tors e g from to of patients e er ho rs
oseltami ir recei ed anti iral treatment incl ding osel
tami ir mg orall e er ho rs At Dosages of oseltami ir from regis
the time of e al ation of patients tered trials either recr iting or not
remained hospitali ed had been dis et recr iting ar b t incl de
charged and had died mg orall dail mg orall once or
t ice dail and 4 6 mg kg orall
While oseltami ir is noted to ha e been freq enc not specified
idel sed for confirmed or s spected
COVID- cases in hospitals in China there

has been no e act e idence to date that
oseltami ir is effecti e in the treatment of
COVID-
Neither oseltami ir nor anami ir has

demonstrated inhibition of c topathic
effect against SARS-CoV in in itro cell c l
t re
Clinicaltrials go trials for COVID- that

incl de oseltami ir
NCT not et recr iting
NCT recr iting
NCT recr iting
Remdesi ir Broad-spectr m anti iral Various clinical trials initiated in US China Optimal dosage and duration of Not commerciall a ailable most prom
Anti iral n cleotide analog pro and other co ntries treatment not known , ising direct-acting anti iral DAA c r
Updated dr g ith acti it against Phase trial protocol se ere COVID- rentl being in estigated for COVID-
ario s ir ses incl ding Randomized, double-blind, placebo- mg IV on da then mg
corona ir ses controlled trial in hospitalized adults with IV dail on da s - arm or Efficac and safet of remdesi ir for
severe COVID- in China (NCT ; mg IV on da then mg IV dail treatment of COVID- not established
In itro e idence of acti it Wang et al): Pts ere randomi ed to on da s - arm mg IV on
against SARS-CoV- in Vero recei e remdesi ir mg IV on da da then mg IV dail on da s NIH COVID- Treatment G idelines
E cells then mg IV once dail on da s - or - e tension arms that incl de pts Panel states that clinical data are ins ffi
placebo initiated ithin da s of s mp ho are or are not recei ing me cient to recommend either for or
In Rhes s macaq es infect tom onset Primar o tcome as time to chanical entilation against the se of remdesi ir for the
ed ith SARS-CoV- treat clinical impro ement ithin da s after Phase trial protocol moderate treatment of COVID-
ment ith a -da regimen randomi ation or hospital discharge hich COVID- mg IV on da then
of IV remdesi ir initiated e er came first ITT pop lation incl ded mg IV on da s - arm or Emergency use authorization (EUA) for
ho rs after ir s inoc pts treated ith remdesi ir and pts mg IV on da then mg IV dail remdesivir: FDA iss ed an EUA on Ma
lation as associated ith treated ith placebo of pts also re on da s - arm that permits se of the dr g for
some benefits lo er dis cei ed interferon α- b also recei ed NIAID adapti e st d protocol the treatment of COVID- onl in hos
ease se erit scores fe er LPV RTV and also recei ed cortico mg IV on da then mg IV for pitali ed ad lts and children ith s s
p lmonar infiltrates lo steroids d ring hospitali ation Median d ration of hospitali ation p to pected or laborator -confirmed COVID-
er ir s titers in bron time to clinical improvement was not sig- da s total ho ha e se ere disease defined as
choal eolar la age sam nificantly different in remdesivir group ( o gen sat ration SpO or lo er
ples compared ith ehi days) vs placebo group ( days); -day Compassionate se access protocol on room air or req iring s pplemental
cle control remdesi ir mortality rate was similar in both groups mg IV on da then mg IV o gen mechanical entilation or
treatment did not red ce ( vs ). When remdesi ir as initiat on da s - ECMO and req ires that the dr g be
iral loads or infectio s ed ithin da s of s mptom onset medi administered b a healthcare pro ider
ir s titers in nose throat an time to clinical impro ement as n Emergency use authorization (EUA) in an inpatient hospital setting ia IV
or rectal s abs compared mericall shorter b t not statisticall sig dosage recommended for adults inf sion at dosages recommended in
ith ehicle control nificant compared ith placebo gro p and children weighing kg or the EUA Distrib tion of remdesi ir
s da s D ration of in asi e mechani more: Loading dose of mg b IV nder this EUA is controlled b the US
In itro acti it against cal entilation as n mericall shorter b t inf sion on da follo ed b go ernment for se consistent ith the
SARS-CoV and MERS-CoV not statisticall significant in remdesi ir mg b IV inf sion once dail on da s terms and conditions of the EUA The
acti e in animal models of gro p onl a small percentage of pts - for pts req iring in asi e me man fact rer Gilead ill s ppl
SARS and MERS pre ented ere on in asi e mechanical chanical entilation and or ECMO remdesi ir to a thori ed distrib tors
MERS in Rhes s macaq es entilation at time of enrollment or follo ed b mg b IV inf sion or directl to a US go ernment agenc
hen gi en before infec Remdesi ir did not res lt in significant re once dail on da s - ith option to ho ill distrib te the dr g to hospitals
tion and pro ided benefits d ction in SARS-CoV- iral load in naso e tend treatment p to da if and other healthcare facilities as di
hen gi en after animal phar ngeal orophar ngeal and sp t m needed for pts not req iring me rected b the US go ernment in collab
alread infected - samples Remdesi ir as discontin ed in chanical entilation and or ECMO oration ith state and local go ernment
Pharmacokinetic data pts beca se of ad erse effects a thorities as needed The EUA re
a ailable from e al ations Note: Enrollment as terminated before Emergency use authorization (EUA) q ires that healthcare facilities and
for Ebola the pre-specified n mber of pts as dosage recommended for children healthcare pro iders administering
attained lack of a ailable pts trial was weighing . to less than kg: remdesi ir compl ith certain manda
insufficiently powered to detect assumed mg kg b IV inf sion on da fol tor record keeping and reporting re
differences in clinical outcome lo ed b mg kg b IV inf sion q irements incl ding ad erse e ent
once dail on da s - for pts re reporting to FDA MedWatch Con
Phase randomized, open-label trial in q iring in asi e mechanical entila s lt the EUA EUA fact sheet for
hospitalized adults with severe COVID- tion and or ECMO or follo ed b healthcare pro iders and EUA fact
(NCT ) sponsored b the man mg kg b IV inf sion once dail sheet for patients and parent caregi ers
fact rer Gilead Initial st d protocol de on da s - ith option to e tend for additional information
signed to e al ate safet and anti iral ac treatment p to da if needed for
ti it of - and -da regimens of pts not req iring mechanical entila
remdesi ir mg IV on da follo ed tion and or ECMO
b mg once dail for total of or
da s in conj nction ith standard of care
in pts not recei ing mechanical entilation
protocol s bseq entl modified to add
e tension arms to e al ate safet and effi
cac of -da regimen of remdesi ir in
conj nction ith standard of care in pts
ho are or are not recei ing mechanical
entilation Manufacturer announced
that data a ailable for the initial pts
not req iring mechanical entilation at
st d entr recei ed a -da regimen
and recei ed a -da regimen indi
cate similar clinical impro ement ith both
treatment d rations Time to clinical im-
provement for of pts was days in
the -day treatment group vs days in
the -day treatment group. At day ,
/ pts ( . ) in the -day group
and / pts ( . ) in the -day
group achieved clinical recovery. Pts ho
recei ed remdesi ir ithin da s of
s mptom onset had impro ed o tcomes
compared ith those treated after more
than da s of s mptoms Note: Data
regarding this initial pt pop lation e g
disease se erit and comorbidities at st d
enrollment additional s pporti e treat
ment recei ed not pro ided to date
Phase randomized, open-label trial in pts

with moderate COVID- (NCT )
sponsored b the man fact rer Gilead is
e al ating safet and anti iral acti it of -
and -da regimens of remdesi ir in con
j nction ith standard of care compared
ith standard of care alone
Phase adaptive, randomized, placebo-

controlled trial (NCT ) in hospital-
ized adults sponsored by NIAID: Pts re
cei ed remdesi ir mg IV on da
then mg once dail for d ration of
hospitali ation p to da s total or pla
cebo Sponsor announced that prelimi
nar data anal sis total of pts indi
cated shorter median time to recovery in
remdesivir group ( days) vs placebo
group ( days) and s ggested that
remdesi ir treatment ma ha e pro ided a
s r i al benefit mortalit rate in
remdesi ir gro p s in placebo
gro p Note: Data regarding the pt pop
lation e g disease se erit and comor
bidities at st d enrollment time to initia
tion of treatment after s mptom onset
additional s pporti e treatment recei ed
not pro ided to date
Expanded access IND protocol

(NCT ): The man fact rer
Gilead has established a protocol for
emergenc access to remdesi ir for the
treatment of se ere ac te COVID-
Compassionate use access: The man fac

t rer Gilead is transitioning from indi id
al compassionate se req ests to an e
panded access program for emergenc
access to the dr g for se erel ill pts ith
confirmed COVID- Ne indi id al com
passionate se req ests cannot be accept
ed ith the possible e ception of req ests
for pregnant omen and children
ears of age ith confirmed infections and
se ere manifestations of the disease
https rd c gilead com
Compassionate use access (NCT ):

Ma be a ailable for DoD personnel
thro gh treatment IND protocol sponsored
b US Arm Medical Research and De elop
ment Command
Data from the manufacturer’s compas-

sionate use program: Preliminar data are
a ailable for a cohort of ad lts from
m ltiple sites in the US Ital Japan and
other co ntries ho ere hospitali ed ith
se ere COVID- and recei ed treatment
ith remdesi ir pts recei ed the f ll -
da regimen mg IV on da then
mg IV on da s - pts recei ed -
da s and pts recei ed less than da s of
treatment ith the dr g At baseline
pts ere recei ing mechanical enti
lation and ere recei ing e tracor
poreal membrane o genation ECMO
O er a median follo - p of da s after
first dose pts sho ed clinical
impro ement based on o gen-s pport
stat s and pts orsened There
ere deaths incl ding pts recei
ing in asi e entilation Ad erse effects
e g increased hepatic en mes diarrhea
rash renal impairment h potension ere
reported in pts pts had
serio s ad erse effects e g m ltiple organ
d sf nction s ndrome septic shock ac te
kidne inj r h potension pts
discontin ed the dr g beca se of ad erse
effects Note: Data presented for this
small cohort of pts offers onl limited infor
mation regarding efficac and safet of
remdesi ir for treatment of COVID-
There as no control gro p and altho gh
s pporti e therap co ld be pro ided at
the discretion of the clinician it is nclear
hether pts at an of the ario s st d
sites also recei ed other therape tic agents
being sed for treatment of COVID- In
addition data ere not presented regard
ing the effects of remdesi ir on iral load
Umifeno ir Broad-spectr m anti iral Retrospective cohort study in ad lts Dosage recommended for treatment Not commerciall a ailable in the US
Arbidol Anti iral ith in itro acti it ith COVID- in China s ggests better of COVID- in China: Ad lts
against ario s ir ses iral s ppression ith mifeno ir s LPV mg orall times dail for no more Incl ded in some g idelines for treat
Updated incl ding corona ir ses RTV All pts recei ed con entional therap than da s ment of COVID-
incl ding interferon α- b At da s after
Altho gh data limited in hospital admission SARS-CoV- as nde Dosage used or being investigated in P blished data to s pport se in treat
itro acti it against SARS- tectable in of pts treated ith COVID- clinical trials: mg oral ment of COVID- c rrentl are limited
CoV- and SARS-CoV- mifeno ir s treated ith LPV-RTV l times dail for d ration of -
reported at da s iral load ndetectable in all pts da s or longer
treated ith mifeno ir s treated
Licensed in China R ssia ith LPV RTV D ration of positi e SARS-
Ukraine and possibl other CoV- RNA positi e test as shorter ith
co ntries for proph la is mifeno ir s LPV-RTV
and treatment of infl en a
Retrospective cohort study in ad lts
ith COVID- in China s ggests more fa
orable o tcome ith LPV RTV pl s
mifeno ir s LPV RTV alone Primar end
point as negati e con ersion in nasopha
r ngeal samples and progression or im
pro ement of pne monia At da s SARS-
CoV- ndetectable in nasophar ngeal
specimens in pts treated ith
LPV RTV pl s mifeno ir s pts
treated ith LPV RTV alone at da s
ndetectable in pts treated
ith both dr gs s pts treated
ith LPV RTV alone At da s chest CT
scans ere impro ing in pts
treated ith both dr gs s pts
treated ith LPV RTV alone
Open-label, prospective, randomized,

multicenter study in ad lts ith
COVID- in China ChiCTR
When fa ipira ir as compared ith
mifeno ir clinical reco er rate as
greater in those treated ith fa ipira ir
than in those treated ith mifeno ir
See Fa ipira ir in this E idence Table
Clinical trials initiated in China:

NCT Randomi ed single-center
open-label trial e al ating efficac of
mifeno ir in conj nction ith standard of
care s LPV RTV in conj nction ith stand
ard of care in ad lts ith COVID-
NCT Randomi ed open-label

trial e al ating efficac and safet of
mifeno ir in conj nction ith standard of
care in ad lts ith COVID-
SUPPORTING AGENTS
Anakinra Disease- Recombinant h man inter C rrentl no kno n p blished clinical trial Vario s dosage regimens are being Ins fficient clinical data to recommend
modif ing Anti le kin- IL- receptor e idence s pporting efficac or safet of st died either for or against se in the treat
Updated -rhe matic antagonist ma poten anakinra in treating COVID- ment of COVID-
Dr g tiall combat c tokine re Trial protocol in Ital COVID- ith
lease s ndrome CRS Enco raging preliminar res lts reported in h perinflammation and respirator Safet profile ell established in pa
s mptoms in se erel ill China ith another disease-modif ing an distress mg b IV inf sion e er tients ith sepsis and has been st died
patients tirhe matic dr g tocili mab ho rs total of mg dail for e tensi el in pediatric patients ith
da s rhe matologic conditions
Italy: Phase randomi ed open-label Some st dies nder a in Greece
m lticenter trial NCT initiated and Belgi m are e al ating mg
b the man fact rer S edish Orphan gi en s bc taneo sl once dail for
Bio itr m to e al ate efficac and safet or da s respecti el or ntil
of anakinra or emapal mab ith standard hospital discharge
of care in red cing h perinflammation and
respirator distress in patients ith COVID- Note Anakinra is appro ed onl for
is recr iting s bc taneo s administration in the
US
Other noncomparati e open-label trials
are recr iting in Greece NCT
NCT and Belgi m
NCT
Ascorbic acid Vitamin Antio idant and cofactor IV ascorbic acid: Vario s dosages of IV ascorbic acid C rrent data not specific to COVID-
C for n mero s ph siologic Phase randomi ed blinded placebo- sed in COVID- st dies mg kg additional st d needed
Updated reactions ma s pport controlled trial NCT LOVIT e al IV e er ho rs for da s sed in
host defenses against in ating effect of high-dose IV ascorbic acid NCT
fection and protect host on mortalit and persistent organ d sf nc
cells against infection- tion in septic ICU patients incl ding COVID- Vario s dosages of IV ascorbic acid
ind ced patients other clinical trials of high- sed in sepsis st dies mg kg e e
o idati e stress - dose IV ascorbic acid for treatment of r ho rs for da s sed in CITRIS-
COVID- also registered ALI st d g e er ho rs ntil
Presence of infection ma NCT shock resol tion or for p to da s
-
decrease itamin C concen NCT sed in VITAMINS st d
trations - NCT
NCT NCT Oral ascorbic acid
NCT dosage of g dail gi en in or
di ided doses
Oral ascorbic acid: Note Ma interfere ith laborator

Randomi ed open-label st d tests based on o idation-red ction
NCT COVIDAtoZ initiated to reactions e g blood and rine gl
e al ate oral ascorbic acid g dail inc cose testing nitrite and bilir bin
or both in combination in s mptomatic concentrations le koc te co nts
o tpatients recei ing a positi e COVID- Man fact rer states to dela o ida
test res lt tion-red ction reaction-based tests
ntil ho rs after inf sion if possi
Incl ded at lo er dosages as an acti e or ble
placebo-eq i alent comparator control in
other COVID- pre ention or treatment
st dies
Incl ded as a component of some h

dro chloroq ine-based combination regi
mens being st died for pre ention or treat
ment of COVID-
Other infections:
Sepsis Meta-anal sis of se eral small st d
ies s ggested beneficial effects from IV
ascorbic acid ho e er primar end points
not impro ed in CITRIS-ALI st d
NCT in patients ith sepsis and
ARDS or in VITAMINS st d NCT
in patients ith septic shock additional
-
st dies nder a
Pne monia Limited st d data a ailable

regarding ascorbic acid oral in hospital
i ed patients ith pne monia
Common cold Effect of oral s pplementa

tion st died e tensi el decreases d ra
tion of s mptoms ma decrease incidence
of common cold in indi id als nder hea
ph sical stress b t not in o erall pop lation
A ithrom cin Antibacterial ith some in Adjunctive therapy in certain respiratory Adjunctive treatment in certain viral C rrent data ins fficient to establish
Macrolides itro acti it against some viral infections: Altho gh contradictor infections: mg once dail has pros and cons of adj ncti e se of
Updated ir ses e g infl en a A res lts reported some e idence of benefi been sed a ithrom cin in management of COVID-
-
H N Zika cial imm nomod lator or anti-
inflammator effects hen sed in pts ith COVID- : mg on da then
No data to date on in itro some iral infections e g infl en a mg dail on da s - in conj nc Additional data needed before an con
acti it against corona Ho e er in a retrospecti e cohort st d tion ith -da regimen of h cl sions can be made regarding possible
ir ses incl ding SARS- in criticall ill pts ith laborator -confirmed dro chloroq ine has been sed benefits of sing a combined regimen of
CoV- MERS there as no statisticall significant h dro chloroq ine and a ithrom cin in
difference in -da mortalit rates or pts ith COVID-
Has imm nomod lator clearance of MERS-CoV RNA bet een those NIH COVID- Treatment G idelines
and anti-inflammator ho recei ed macrolide therap and those Panel recommends against the se of a
effects incl ding effects on ho did not combined regimen of h dro chloro
proinflammator c to q ine and a ithrom cin for the treat
kines precise mechanisms Adjunctive therapy in certain respiratory ment of COVID- e cept in the conte t
of s ch effects not f ll conditions: Some e idence of beneficial of a clinical trial See H dro chloro
-
el cidated imm nomod lator or anti-inflammator q ine in this E idence Table
Has been sed as adj nc effects hen sed in pts ith certain res
ti e therap to pro ide pirator conditions e g ARDS In a ret IDSA recommends that a combined
antibacterial co erage and rospecti e cohort st d in pts ith moder regimen of h dro chloroq ine and
potential imm nomod la ate or se ere ARDS a statisticall signifi a ithrom cin be sed for the treatment
tor and anti-inflammator cant impro ement in -da s r i al as of COVID- onl in the conte t of a
effects in the treatment of reported in those ho recei ed adj ncti e clinical trial
some iral respirator tract a ithrom cin
infections e g infl en a Beca se both a ithrom cin and h
Clinical experience in pts with COVID- : dro chloroq ine are associated ith
Has been sed for antibacterial co erage in QT prolongation ca tion is ad ised if
Has been sed as adj nc hospitali ed pts ith COVID- considering se of both dr gs in pts at
ti e therap to pro ide risk for QT prolongation or recei ing
antibacterial co erage and Use in conjunction with hydroxychloro- other dr gs associated ith arrh thmi
potential imm nomod la quine in pts with COVID- : A ithrom cin as diagnostic testing and monitoring
tor and anti-inflammator mg on da then mg dail on recommended to minimi e risk of ad
effects in the management da s - has been sed in addition to a - erse effects incl ding dr g-ind ced
of certain respirator con da regimen of h dro chloroq ine cardiac effects
ditions e g bronchiecta mg dail in an open-label nonrandomi ed
sis bronchiolitis c stic st d in France pts open-label ncon
fibrosis COPD e acerba trolled st d in France pts and n
tions ARDS controlled obser ational st d in France
pts Data presented to date are in
s fficient to e al ate possible clinical bene
fits of a ithrom cin in pts ith COVID-
See H dro chloroq ine in this E idence
Table
Baricitinib Disease- Jan s kinase JAK and C rrentl no kno n p blished clinical trial Therape tic dosages of baricitinib Minimal interaction ith CYP en mes
modif ing Anti inhibitor disr pts reg la e idence s pporting efficac or safet in or mg orall once dail are s ffi and dr g transporters and lo protein
Ol miant -rhe matic tors of endoc tosis AP - patients ith COVID- cient to inhibit AAK binding of baricitinib allo for com
Dr g associated protein kinase bined se ith anti iral agents and oth
Updated AAK and c clin G- Baricitinib to be incl ded as an arm in Dosage information not et a ailable er dr gs
associated kinase GAK NIAID’s Adapti e COVID- Treatment Trial see Trials or Clinical E perience
hich ma help red ce NIH COVID- Treatment G idelines
iral entr and inflamma Panel recommends against se of JAK
tion also ma interfere Adaptive phase / clinical trial: Open- inhibitors for the treatment of COVID-
ith intracell lar ir s label st d planned to e al ate safet and e cept in the conte t of a clinical
particle assembl efficac of baricitinib in hospitali ed pa trial the panel states that at present
tients ith COVID- NCT the broad imm nos ppressi e effect of
Inhibits JAK and JAK - JAK inhibitors o t eighs the potential
mediated c tokine release for benefit
ma combat c tokine
release s ndrome CRS in Other planned clinical trials ill e al ate

se erel ill patients baricitinib in combination ith or itho t
an anti iral agent for the treatment of
Abilit to inhibit a ariet COVID- NCT NCT
of proinflammator c to NCT NCT
kines incl ding interferon
has been raised as a possi
ble concern ith the se of
JAK inhibitors in the man
agement of h perinflam
mation res lting from iral
infections s ch as COVID-
Colchicine An E erts broad anti- Minimal anecdotal e perience and no clini Dosage in NCT Colchicine Safet and efficac for treatment of
tigo t Agents inflammator and im cal trial data reported to date in COVID- mg orall t ice dail for da s COVID- not established
Added m nomod lator effects then mg once dail for da s
thro gh m ltiple mecha Phase , randomized, double-blind, place-
nisms incl ding inhibition bo-controlled study NCT COL Consider possible need for colchicine
of NOD-like receptor pro CORONA initiated in ad lts ith COVID- dosage adj stment man fact rer-
tein NLRP inflam and at least one high-risk criterion to e al recommended dosages for labeled
masome assembl and ate effect of colchicine on mortalit hospi indications depend on patient s age
disr ption of c toskeletal tali ation rate and need for mechanical renal and hepatic f nction and con
f nctions thro gh inhibi entilation st d e cl des enrollment of comitant se of interacting dr gs
tion of microt b le c rrentl hospitali ed patients enrollment incl ding protease inhibitors e g
pol meri ation target is appro imatel pts lopina ir ritona ir other moderate
or potent CYP A inhibitors and P-
Ma combat the h per- Other registered randomi ed open-label gl coprotein P-gp inhibitors
inflammator state of parallel-gro p st dies not et recr iting
COVID- e g c tokine ill e al ate effects of colchicine pl s Use of colchicine in patients ith
storm b s ppressing standard treatment s standard treatment renal or hepatic impairment recei
proinflammator c tokines alone on ario s o tcome meas res e g ing P-gp inhibitors or potent CYP A
and chemokines mortalit markers of m ocardial damage inhibitors is contraindicated
clinical stat s need for mechanical entila
NLRP inflammasone acti tion d ration of hospitali ation in ad lts
ation res lts in release of ith COVID- NCT
interle kins incl ding IL- NCT
β NCT NCT
NCT
In e perimental models of
ac te respirator distress
s ndrome ac te l ng inj
r ARDS ALI the NLRP
inflammasome had a major
role in the de elopment of
l ng inj r
Potential to limit COVID- -

related m ocardial damage
also has been h pothesi ed
based on the dr g’s
mechanisms of action and
promising res lts of ongoing
research on colchicine in
ario s cardiac conditions
-
SARS-CoV- en elope E
protein a iroporin in ol ed
in replication and ir lence
acti ates the NLRP inflam
masome in itro in Vero E
cells b forming calci m-
permeable ion channels
leading to increased IL- β
prod ction
Corticoster Potent anti-inflammator Observational studies: E idence s ggests In general lo to moderate dosages Data on the se of corticosteroids in
oids general Adrenals and antifibrotic properties that corticosteroid se in patients ith of corticosteroids are recommended COVID- are limited The
se of corticosteroids ma SARS MERS and infl en a as associated in int bated patients ith ARDS benefits and risks of corticosteroid ther
Updated pre ent an e tended c to ith no s r i al benefit and possible harm ap sho ld be caref ll eighed before
kine response and ma e g dela ed iral clearance a asc lar Regimens sed in China ere t pi se in patients ith COVID-
accelerate resol tion of necrosis ps chosis diabetes call meth lprednisolone - mg
p lmonar and s stemic IV dail for a co rse of - da s NIH CDC WHO IDSA and other e perts
inflammation in pne monia Uncontrolled obser ational data from the Some e perts s ggest that eq i a ha e iss ed g idelines for the se of
recent COVID- o tbreak in China s ggest lent dosages of de amethasone i e corticosteroids in patients ith COVID-
a possible treatment benefit of - mg dail t picall mg dail based on the c rrentl a ailable in
E idence s ggests that c to meth lprednisolone in COVID- patients ma ha e an ad antage of prod c formation Recommendations are made
kine storm a h perinflam ith ac te respirator distress s ndrome ing less fl id retention since de a according to the se erit of illness indi
mator state resembling ARDS See Meth lprednisolone in this methasone has less mineralocorti cations and nderl ing medical condi
secondar hemophagoc tic E idence Table coid acti it This dosage of de a tions and sho ld be considered on a
l mphohistioc tosis HLH methasone is consistent ith those case-b -case basis
is a contrib ting factor in Pending res lts of randomi ed controlled sed in the DEXA-ARDS trial
COVID- -associated mor clinical st dies specificall e al ating corti General recommendations: WHO CDC
talit Imm nos ppres costeroids for COVID- indirect e idence Higher dosages ha e been s ggest NIH and IDSA generall recommend
sion from corticosteroids from st dies in patients ith comm nit - ed for c tokine storm See Com against the ro tine se of corticoster
has been proposed as a acq ired pne monia ARDS and other iral ments col mn oids for the treatment of COVID- n
treatment option for s ch infections has been sed to inform treat less indicated for another reason e g
h perinflammation ment decisions for COVID- patients asthma or COPD e acerbation refracto
-
r septic shock
Ma impro e d sreg lated
imm ne response ca sed S stemic corticosteroid therap has been Non-critical patients: Corticosteroids
b sepsis possible compli st died in se eral randomi ed controlled generall sho ld not be sed in the
cation of infection ith st dies for the treatment of ARDS o erall treatment of earl or mild disease since
COVID- and increase BP e idence is lo to moderate in q alit and the dr gs can inhibit imm ne response
hen lo
most st dies ere performed prior to the red ce pathogen clearance and in
prel ng protection strateg era crease iral shedding
In a recent m lticenter nblinded ran
domi ed controlled st d DEXA-ARDS NIH recommends against the ro tine
trial the effects of de amethasone in con se of s stemic corticosteroids for the
j nction ith con entional care ere e al treatment of COVID- in hospitali ed
ated in hospitali ed patients ith moder patients nless the are in the intensi e
ate-to-se ere ARDS recei ing l ng- care nit
protecti e mechanical entilation Treat
ment ith IV de amethasone at a dosage Critically ill patients: The S r i ing
of mg once dail on da s - follo ed Sepsis Campaign COVID- s bcom
b mg once dail on da s - res lted mittee a joint initiati e of the Societ of
in red ced d ration of mechanical entila Critical Care Medicine and the E ropean
tion and red ced o erall mortalit i e Societ of Intensi e Care Medicine
increase in -da s r i al compared recommends against the ro tine se of
ith con entional treatment alone s stemic corticosteroids in mechanicall
Based on res lts of this st d a clinical trial entilated ad lts ith COVID- and
NCT has been initiated to spe respirator fail re itho t ARDS
cificall e al ate the se of de amethasone Ho e er these e perts generall s p
in patients ith ARDS d e to COVID- port a weak recommendation to se
lo -dose short-d ration s stemic corti
Other clinical trials ha e been initiated in costeroids in the sickest patients ith
ario s co ntries to e al ate se of IV cor COVID- and ARDS
ticosteroids e g de amethasone h dro
cortisone oral corticosteroids e g pred NIH also recommends against the ro
nisone or inhaled corticosteroids e g tine se of s stemic corticosteroids for
b desonide for treatment of COVID- the treatment of mechanicall entilat
pne monia or ARDS incl ding the follo ed COVID- patients itho t ARDS
ing trials registered at clinicaltrials go Ho e er the NIH panel states that
NCT there is ins fficient e idence for or
NCT against the se of s stemic corticoster
NCT oids in mechanicall entilated patients
NCT ith COVID- and ARDS
NCT
NCT IDSA s ggests against sing corticoster
NCT oids in hospitali ed patients ith COVID
For registered clinical trials e al ating se - pne monia ho e er in those ith
of meth lprednisolone see Meth lpredni ARDS d e to COVID- s stemic corti
solone in this E idence Table costeroids ma be sed in the conte t
of a clinical trial
Randomi ed controlled st dies e al ating
se of corticosteroids e g h drocortisone Cytokine storm: There is no ell-
de amethasone meth lprednisolone established or e idence-based treat
prednisolone in septic shock s ggest a ment for c tokine storm in patients ith
small b t ncertain mortalit red ction COVID- Ho e er some e perts
s ggest that se of more potent imm
nos ppression ith corticosteroids ma
be beneficial in s ch patients These
e perts s ggest higher dosages of corti

costeroids e g IV meth lprednisolone
- mg e er ho rs for p to
da s follo ed b tapering of the dose
hen inflammator markers e g C-
reacti e protein le els begin to de
crease The decision to se cortico
steroids in patients ith earl signs of
c tokine storm sho ld be balanced ith
the kno n ad erse effects
Septic shock: The effect of corticoster

oids in COVID- patients ith sepsis or
septic shock ma be different than the
effects seen in those ith ARDS The
S r i ing Sepsis Campaign and NIH s g
gest the se of lo -dose corticosteroid
therap e g h drocortisone mg
dail as an IV inf sion or intermittent
doses o er no corticosteroid therap in
ad lts ith COVID- and refractor
shock
Clinicians considering corticosteroids for
s ch patients ith COVID- sho ld
balance the potential small red ction in
mortalit ith potential effects of pro
longed corona ir s shedding If corti
costeroids are prescribed monitor and
treat ad erse effects incl ding h pergl
cemia h pernatremia and h pokale
mia
Patients receiving corticosteroid thera-

py for chronic conditions NIH states
that oral corticosteroids sed for the
treatment of an nderl ing condition
prior to COVID- infection e g prima
r or secondar adrenal ins fficienc
rhe matologic diseases sho ld not be
discontin ed S pplemental or stress
dosages of corticosteroids ma be indi
cated on an indi id al basis in patients
ith s ch conditions The g idelines also
recommend that inhaled corticosteroids
sed dail for the management of asth
ma and COPD to control air a inflam
mation sho ld not be discontin ed in
patients ith COVID-
Endocrinolog e perts state that pa

tients ith primar or secondar adrenal
ins fficienc ho are recei ing pro
longed corticosteroid therap sho ld
follo s al steroid “sick da r les”
since these indi id als ma not be able
to mo nt a normal stress response in
the e ent of COVID- infection If
s ch indi id als de elop s mptoms s ch
as fe er and a dr contin o s co gh
the sho ld immediatel do ble their
dail oral corticosteroid dosage and
contin e ith this regimen ntil the
fe er s bsides These g idelines also
appl to patients ho are recei ing pro
longed therap months ith corti
costeroids for nderl ing inflammator
conditions incl ding asthma allerg
and rhe matoid arthritis In s ch pa
tients hose condition orsens or in
those e periencing omiting or diarrhea
treatment ith parenteral corticoster
oids ma be necessar Administra
tion of ph siologic stress doses of corti
costeroids e g IV h drocortisone -
mg times dail and not pharma
cologic doses sho ld be considered in all
cases to a oid potentiall fatal adrenal
fail re Additional st d is needed to
determine the optim m corticosteroid
stress dosage regimens in patients ith
COVID- There is some e idence
s ggesting that contin o s IV inf sion of
h drocortisone follo ing an initial IV
bol s dose ma pro ide more stable
circ lating cortisol concentrations in
patients ith adrenal ins fficienc and
red ce the potentiall harmf l effects of
peak and tro gh concentrations of corti
sol on the imm ne s stem
Pregnancy considerations: For pregnant

omen ith COVID- NIH g idelines
state that the antenatal se of cortico
steroids that cross the placenta i e
betamethasone de amethasone is
generall reser ed for hen administra
tion is req ired for fetal benefit Other
s stemic corticosteroids do not cross

the placenta and pregnanc is not a
reason to restrict their se if other ise
indicated ACOG recommends against
administration of antenatal corticoster
oids for fetal benefit in the late preterm
period i e eeks and da s
thro gh eeks and da s in pa
tients ith s spected or confirmed
COVID- beca se the benefits of s ch
therap in late preterm are less ell
established Treatment sho ld be indi
id ali ed eighing the neonatal bene
fits of antenatal corticosteroid therap
ith the risks of potential harm to the
pregnant patient
COVID- Theoreticall plasma ob Uncontrolled pilot study of COVID- con- Efficac and safet of COVID- con a
Con alescent tained from pts ho ha e valescent plasma in China: Ten ad lts ith lescent plasma for the treatment of
Plasma reco ered from COVID- se ere COVID- recei ed a single transf COVID- not established
i e COVID- con ales sion of COVID- con alescent plasma
Added cent plasma that contains containing SARS-CoV- ne trali ing anti Most appropriate criteria for selection
antibodies against SARS- bod titers of or greater with stand- of pts to recei e in estigational COVID-
CoV- incl ding ne trali ard care pts also recei ed mifeno ir con alescent plasma optimal time
ing antibod ma pro ide Arbidol some pts also recei ed riba irin d ring the co rse of the disease to re
short-term passi e imm n oseltami ir perami ir and or interferon α, cei e s ch therap and appropriate
it that co ld pre ent in and pts also recei ed meth lpredniso dosage e g ol me n mber of doses
fection or co ld be benefi lone Time from onset of s mptoms to not determined -
cial in the treatment of pts transf sion of con alescent plasma as -
ith COVID- in terms of da s mean da s COVID- s mp Optimal timing of donor plasma collec
decreasing iral load and toms fe er co gh shortness of breath tion in relation to reco er from COVID-
impro ing o tcomes - chest pain impro ed in all pts ithin - most appropriate methods of anti
da s after the transf sion and all pts bod testing and minim m titers of
In SARS pts in - sho ed impro ement on chest CTs Titers SARS-CoV- antibod in con alescent
se of con alescent plasma of ne trali ing antibod increased in pts plasma that ma be associated ith
obtained from pts ho had after the transf sion b t did not increase clinical benefits in pts ith COVID-
reco ered from the disease in pts Prior to the transf sion RT-PCR not determined -
as reported to pro ide tests for SARS-CoV- RNA ere positi e in
some benefits e g short pts and negati e in pts after transf sion Logistics of obtaining processing stor
er d ration of hospitali a SARS-CoV- RNA as ndetectable in pts ing and distrib ting COVID- con ales
tion decreased mortalit on da pts on da and pt on da cent plasma e ol ing - FDA
-
SARS pts ho re does not collect COVID- con alescent
cei ed con alescent plas plasma and does not pro ide s ch plas
ma less than da s after Uncontrolled case series in China: Fi e ma healthcare pro iders and ac te care
onset of s mptoms had criticall ill ad lts ith rapidl progressing facilities obtain COVID- con alescent
better o tcomes than se ere COVID- and ac te respirator plasma from FDA-registered establish
those ho recei ed s ch distress s ndrome ARDS req iring me ments
plasma later in the co rse chanical entilation ho had high iral
-
of the disease loads despite anti iral treatment recei ed
transf sions of COVID- con alescent Potential risks associated ith COVID-
plasma containing SARS-CoV- ne trali ing con alescent plasma therap e g inad
antibod end point dil tion titers of - ertent transmission of other infectio s
depending on the donor in conjunction agents allergic reactions thrombotic
with contin ed meth lprednisolone thera complications transf sion-associated
p and ario s anti iral treatments that circ lator o erload transf sion-related
incl ded LPV RTV fa ipira ir mifeno ir ac te l ng inj r TRALI antibod -
Arbidol dar na ir and or interferon α- dependent enhancement that ma e
b Pts recei ed the con alescent plasma acerbate clinical se erit and steps to
transf sions - da s after hospital ad mitigate s ch risks not determined -
mission Follo ing the transf sions bod
temperat re normali ed ithin da s in
pts seq ential organ fail re assess FDA issued a guidance for industry to
ment SOFA scores impro ed in all pts provide recommendations to
decreased from initial scores of - to - healthcare providers and investigators
on da titers of SARS-CoV- IgG IgM regarding administration and study of
and ne trali ing antibod increased in all investigational COVID- convalescent
pts and iral loads decreased and became plasma This g idance doc ment in
negati e ithin da s cl des recommendations regarding
path a s for access to COVID- con a
Efficacy data not available from controlled lescent plasma pt eligibilit criteria to
clinical studies to date. recei e s ch plasma collection of s ch
plasma incl ding donor eligibilit and
Multiple clinical trials initiated in the US q alifications prod ct labeling and
and other countries to e al ate se of recordkeeping
COVID- con alescent plasma incl ding
the follo ing trials registered at clinicaltri FDA states that COVID- convalescent
als go plasma is regulated as an investigation-
NCT US al product and there currently are
NCT US available pathways for administering
NCT US or studying use of such plasma
NCT US Clinical Trials: Req ests to st d se
NCT US of COVID- con alescent plasma
NCT US sho ld be s bmitted to FDA nder the
NCT US traditional in estigational ne dr g
NCT US IND reg lator path a
NCT Expanded Access IND: For pts ith
NCT serio s or immediatel life-threatening
NCT COVID- ho are not eligible or are
NCT nable to participate in randomi ed
NCT critical trials an e panded access IND
NCT can be sed A National E panded Ac
NCT cess Treatment Protocol has been es
NCT tablished to facilitate access thro gh
NCT participation of ac te care facilities
NCT nder an IND that is alread in place
Information on a protocol that is in
place is a ailable at https

sco idplasma org
Single Patient Emergency IND
(eIND) Licensed ph sicians seeking to
administer COVID- con alescent plas
ma to an indi id al pt ma req est an
eIND from the FDA Cons lt the FDA
g idance doc ment for specific infor
mation on appl ing for an eIND
FDA g idance s ggests that collection of

donor plasma at least da s after
complete resol tion of s mptoms or
collection at least da s after resol
tion of s mptoms and negati e res lts
for COVID- based on one or more
nasophar ngeal s abs or b a molec
lar diagnostic blood test be considered
FDA g idance s ggests that a minim m

ne trali ing antibod titer of at least
in donor plasma sho ld be consid
ered
FDA g idance s ggests that the follo

ing pt eligibilit criteria to recei e COVID
- con alescent plasma be considered
Laborator -confirmed COVID- ith
severe disease defined as one or more
of the follo ing shortness of breath
respirator freq enc min te or
greater blood o gen sat ration or
lo er PaO FiO ratio less than
l ng infiltrates greater than ithin
- ho rs or ith life-threatening
disease defined as one or more of the
follo ing respirator fail re septic
shock m ltiple organ d sf nction or
fail re and informed consent pro ided
b the pt or healthcare pro
Epoprostenol Selecti e p lmonar aso No st dies e al ating se specificall in Vario s dosages of inhaled epo Additional st dies are needed to e al
inhaled Vasodilating dilator ma be sef l in COVID- patients prostenol ha e been sed in ARDS ate the potential role of inhaled epo
Agent the adj ncti e treatment st dies prostenol in the treatment of ARDS -
Added of ac te respirator dis E perience in patients ith ARDS indicates
tress s ndrome ARDS a that inhaled epoprostenol can s bstantiall Dosages p to ng kg per min te The S r i ing Sepsis Campaign states
potential complication of red ce mean p lmonar arter press re ha e been sed titrated to re that d e to the lack of adeq atel po
-
COVID- and impro e o genation in s ch patients sponse - To pro ide a clinicall ered randomi ed controlled st dies
Inhaled epoprostenol has ho e er data demonstrating clinical bene important increase in PaO and re a recommendation cannot be made for
been s ggested as an alter fit are lacking - d ction in p lmonar arter pres or against se of inhaled prostac clins in
nati e to inhaled nitric s re data from these st dies s ggest COVID- patients ith se ere ARDS
o ide d e to its similar that the most effecti e and safe dos
efficac lo er potential age appears to be - ng kg per
for s stemic ad erse min te in ad lts and ng kg per
effects lo er cost and min te in pediatric patients
ease of deli er
Meth lpred- Potent anti-inflammator Retrospective, observational, single-center Dosage sed in the retrospecti e Findings from obser ational st dies
nisolone Adrenal and antifibrotic properties study: In patients ith confirmed st d W et al not pro ided s ggest that for patients ith COVID-
DEPO- se of corticosteroids ma COVID- pne monia ho de eloped pne monia ho progress to ARDS
Medrol pre ent an e tended c to ARDS meth lprednisolone appeared to Dosage sed in the retrospecti e meth lprednisolone treatment ma be
SOLU- kine response and ma red ce the risk of death Among patients st d Wang et al as - mg kg beneficial Ho e er res lts sho ld be
Medrol accelerate resol tion of ith ARDS of those ho recei ed dail IV for - da s interpreted ith ca tion beca se of
p lmonar and s stemic meth lprednisolone treatment of potential bias dr g sed in sickest pa
Updated inflammation in pne mo patients died hile of those ho did Dosage sed in the randomi ed tients and small sample si e Confirma
nia not recei e meth lprednisolone of controlled st d NCT as tion from randomi ed controlled st dies
died mg IV e er ho rs for da s is needed
See Corticosteroids in this See Corticosteroids in this E idence
E idence Table Retrospective, observational, single-center Table
study: In patients ith confirmed se
ere COVID- pne monia that progressed
to ac te respirator fail re se of
meth lprednisolone as associated ith
impro ement in clinical s mptoms i e
fe er h po ia and a shortened disease
co rse in patients ho recei ed the dr g
compared ith those ho did not
Death occ rred in patients d ring hospi
tali ation of these patients recei ed
meth lprednisolone
Open-label, multicenter, randomized con-

trolled study NCT as recentl
completed in China that compared se of
meth lprednisolone in conj nction ith
standard care in patients ith confirmed
COVID- infection that progressed to
ac te respirator fail re res lts ha e not
et been posted
M ltiple clinical trials ha e been initiated in

ario s co ntries to e al ate se of
meth lprednisolone for treatment of
COVID- pne monia or se ere ac te res
pirator s ndrome incl ding the follo ing
trials registered at clinicaltrials go
NCT
NCT
NCT
NCT
NCT
A non-randomi ed pilot st d registered at

clinicaltrials go NCT has been
initiated to e al ate se of meth lpredni
solone for the pre ention of COVID-
c tokine storm and progression to respira
tor fail re
Nitric o ide Vaso Selecti e p lmonar aso No st dies e al ating se specificall in In the Chen et al st d in se ere Therape tic g idelines for the treat
inhaled dilating dilator ma be sef l in COVID- patients SARS patients inhaled nitric o ide ment of ARDS state that inhaled nitric
Agent the adj ncti e treatment therap as gi en for 3 da s o ide ma be considered in patients
Updated of ac te respirator dis In a small pilot st d Chen et al cond ct ppm on da follo ed ith se ere h po emia not responsi e
tress s ndrome ARDS a ed in China d ring the SARS-CoV o t b and ppm on da s and to con entional entilation strategies
potential complication of break treatment ith inhaled nitric o ide respecti el then eaned on da ho e er ro tine se not recommend
COVID- in ICU patients ith SARS re ersed p lmo therap as res med at ppm if ed
nar h pertension impro ed se ere h po deteriorating o genation occ rred
In itro e idence of direct ia and shortened the d ration of entilato The S r i ing Sepsis Campaign s ggests
anti iral acti it against r s pport a trial of inhaled p lmonar asodilator
se ere ac te respirator Phase clinical trial protocol therap as resc e therap in mechani
s ndrome corona ir s Randomi ed controlled st dies of inhaled NCT for treatment of call entilated ad lts ith COVID-
SARS-CoV genetic simi nitric o ide in ARDS patients generall mechanicall entilated COVID- se ere ARDS and h po emia despite
larit bet een SARS-CoV demonstrated modest impro ements in patients ppm for the first optimi ed entilation and other resc e
and SARS-CoV- s ggests o genation b t no effect on mortalit and ho rs follo ed b ppm and then strategies if rapid impro ement in o
potential effecti eness for possible harm e g renal impairment s bseq entl ean genation is not obser ed treatment
COVID- sho ld be tapered off
Clinical trials e al ating inhaled nitric

o ide for the treatment or pre ention of
COVID- are planned or nder a
NCT NCT
NCT NCT
On March th Bellerophon Ther

ape tics anno nced that the FDA grant
ed emergenc e panded access allo ing
its inhaled nitric o ide deli er s stem
INOp lse to be immediatel sed for
the treatment of COVID-
R olitinib Jan s kinase JAK and C rrentl no kno n p blished clinical trial Vario s dosages are being e al ated NIH COVID- Treatment G idelines
Jakafi Antineoplastic inhibitor ma potentiall e idence s pporting efficac or safet in Panel recommends against se of JAK
Agents combat c tokine release patients ith COVID- Phase st d NCT R inhibitors for the treatment of COVID-
Updated s ndrome CRS in se erel olitinib mg t ice dail e cept in the conte t of a clinical
ill patients Phase randomized, double-blind, place- for da s ith possible trial the panel states that at present
bo-controlled clinical trial NCT e tension to da s
Abilit to inhibit a ariet RUXCOVID e al ating r olitinib pl s the broad imm nos ppressi e effect of
of proinflammator c to standard of care s standard of care alone JAK inhibitors o t eighs the potential
kines incl ding interferon is being initiated in patients 12 ears of for benefit
has been raised as a possi age ith COVID- -associated c tokine
ble concern ith the se of storm sponsored b Inc te in U S and
JAK inhibitors in the man No artis o tside of U S
agement of h perinflam
mation res lting from iral Expanded-access (managed-access, com-
infections s ch as COVID- passionate use) program NCT
a ailable for eligible ad lts and children 6
ears of age ith severe or very severe
COVID- illness address inq iries to In
c te - - or me
dinfo inc te com
Expanded-access program NCT

a ailable for emergenc treatment of cyto-
kine storm from COVID- infection in
ad lts and pediatric patients 12 ears of
age address inq iries to Inc te - -
or medinfo inc te com
Other earlier-phase smaller and or open-

label clinical trials registered
NCT
NCT
NCT
NCT
NCT
NCT
NCT
ChiCTR in Chinese Clinical Trial
Registr
Saril mab Disease- Recombinant h mani ed C rrentl no kno n p blished clinical trial Not a ailable see Trials or Clinical NIH COVID- Treatment G idelines
Kef ara modif ing Anti monoclonal antibod spe e idence s pporting efficac or safet in E perience Panel states that there are ins fficient
-rhe matic cific for the interle kin- treatment of patients ith COVID- clinical data to recommend either for
Updated Dr g IL- receptor ma poten or against se of saril mab in the treat
tiall combat c tokine re Ho e er based on enco raging res lts in ment of COVID-
lease s ndrome CRS and China ith a similar dr g tocili mab a
p lmonar s mptoms in U S -based phase randomi ed do ble-
se erel ill patients blind placebo-controlled st d e al ating
efficac and safet of saril mab in patients
hospitali ed ith se ere COVID- is c r
rentl nder a
Clinicaltrials go link https

clinicaltrials go ct sho NCT
term saril mab dra rank
For compassionate use access or investiga-
tor-sponsored clinical studies, contact the
manufacturer (Sanofi Genzyme) for fur-
ther information ( - - - )
Sirolim s Imm mTOR comple In an open-label prospecti e randomi ed Dosage being in estigated in Altho gh possible clinical application
Rapam ne nos ppressi e mTORC is in ol ed in st d in patients ith confirmed H N NCT trial mg orall on c rrent data not specific to COVID-
agent mTOR the replication of ario s pne monia treatment ith sirolim s mg da follo ed b mg dail for a additional st d needed
Updated inhibitor ir ses incl ding corona dail in conj nction ith corticosteroids for ma im m treatment d ration of
ir s da s as associated ith impro ed pa da s or ntil hospital discharge
tient o tcomes e g shortened d ration of
In itro st dies demon mechanical entilation impro ed h po ia
strated inhibitor acti it and m ltiorgan f nction
against MERS-CoV infec
tion A randomi ed do ble-blind placebo-
controlled trial NCT has been
initiated to e al ate the se of sirolim s in
hospitali ed patients ith COVID-
Tocili mab Disease- Recombinant h mani ed Case reports and obser ational st dies IV inf sion China recommends an In China tocili mab can be sed to
Actemra modif ing Anti monoclonal antibod spe describing se of tocili mab in patients initial dose of 4 mg kg inf sed treat se erel or criticall ill COVID-
-rhe matic cific for the interle kin- ith COVID- reported from ario s areas o er more than min tes If initial patients ith e tensi e l ng lesions and
Updated Dr g IL- receptor ma poten of the orld dose not effecti e ma administer high IL- le els
tiall combat c tokine re In preliminar data from a non-peer- second dose in same dosage as ini
lease s ndrome CRS re ie ed single-arm obser ational Chi tial dose after ho rs No more NIH COVID- Treatment G idelines
s mptoms in se erel ill nese trial X et al in ol ing patients than doses sho ld be gi en ma i Panel states that there are ins fficient
COVID- patients - ith se ere or critical COVID- infection m m single dose is mg clinical data to recommend either for
patients demonstrated rapid fe er red c US/Global randomized, placebo- or against se of tocili mab in the
tion and a red ced need for s pplemental controlled trial (manufacturer spon- treatment of COVID-
o gen ithin se eral da s after recei ing sored; COVACTA): Will e al ate an
tocili mab initiall gi en as a single - initial IV inf sion of mg kg p to a The role of ro tine c tokine meas re
mg dose b IV inf sion this dose as re ma im m dose of mg one addi ments e g IL- CRP in determining
peated ithin ho rs in patients be tional dose ma be gi en if s mp the se erit of and treating COVID-
ca se of contin ed fe er toms orsen or sho no impro e req ires f rther st d
In a retrospecti e obser ational st d in ment
China L o et al in ol ing patients
moderatel to criticall ill ith COVID-
tocili mab - mg per dose as gi
en and as sed in conj nction ith
meth lprednisolone in of the patients
Abo t one-third of the patients recei ed
or more doses of tocili mab Ele ated C-
reacti e protein CRP le els rapidl de
creased in most patients follo ing treat
ment and a grad al decrease in IL- le els
as noted in patients ho stabili ed fol
lo ing tocili mab administration Clinical
o tcomes ere eq i ocal
A single-center retrospecti e obser ation
al st d of kidne transplant recipients
in Ital ith COVID- hospitali ed for
pne monia incl ded patients ho re
cei ed tocili mab Half of the patients
e perienced red ced o gen req irements
and sho ed impro ed radiologic
findings follo ing administration
of the tocili mab-treated patients died
Zhang et al from China reported on a pa

tient ith COVID- and m ltiple m eloma
ho appeared to be s ccessf ll treated
ith tocili mab
C rrentl there are no ell-controlled

p blished st dies on the efficac and safe
t of tocili mab for the treatment of
COVID- ho e er n mero s clinical
trials are planned or nder a globall
China Randomi ed m lticenter con

trolled clinical trial e al ating efficac
safet in patients ith COVID- n
der a thro gh Results not yet
available. Chinese Clinical Trial Registr
link http chictr org cn
sho projen asp proj
US/Global randomized, placebo-

controlled trial: Man fact rer Roche
cond cting a randomi ed do ble-blind
placebo-controlled phase trial
COVACTA NCT in collaboration
ith the US Health and H man Ser ices’
Biomedical Ad anced Research and De el
opment A thorit BARDA the st d ill
e al ate safet and efficac of tocili mab
in combination ith standard of care com
pared ith placebo E pected to enroll
abo t patients globall incl ding in
the U S beginning in April
OTHER
ACE Inhibi Renin- Hypothetical harm: H man Data are lacking no e idence of harm or American Heart Association AHA Amer
tors Angio Angiotensin- pathogenic corona ir ses benefit ith regards to COVID- infec ican College of Cardiolog ACC Heart
tensin II Re Aldosterone bind to their target cells tion Fail re Societ of America HFSA E ro
ceptor Block S stem Inhib thro gh angiotensin- Clinical trial nder a Initiation of losar pean Societ of Cardiolog ESC recom
ers ARBs itor con erting en me tan in ad lt patients ith COVID- req ir mend to contin e treatment ith renin-
ACE E pression of ing hospitali ation primar o tcome angiotensin-aldosterone s stem RAAS
Updated ACE ma be increased in meas re seq ential organ fail re assess antagonists in those patients ho are
patients treated ith ACE ment SOFA respirator score c rrentl prescribed s ch agents
inhibitors or ARBs In NCT
creased e pression of ACE NIH COVID- Treatment G idelines Pan
ma potentiall facilitate el states patients ho are recei ing an
COVID- infections ACE inhibitor or ARB for cardio asc lar
disease or other indications sho ld con
Hypothetical benefit: ACE tin e recei ing these dr gs recommends
inhibitors or ARBs ma ha e against se of ACE inhibitors or ARBs for
a protecti e effect against the treatment of COVID- e cept in the
l ng damage or ma ha e conte t of a clinical trial
parado ical effect in terms
of ir s binding Patients ith cardio asc lar disease are
at an increased risk of serio s COVID-
infections
Abr pt ithdra al of RAAS inhibitors in

high-risk patients e g heart fail re pa
tients patients ith prior m ocardial
infarction ma lead to clinical instabilit
and ad erse health o tcomes
Anticoag There is increasing e idence Limited data from a retrospecti e st d in Additional st d is needed to nderstand
lants lo Heparins that patients ith se ere China s ggest that patients ith se ere the anticoag lant needs of COVID-
molec lar COVID- de elop a h per COVID- infection or markedl ele ated patients Se eral organi ations
eight hepa coag lable state hich has le els of D-dimer ULN ma ha e ha e p blished interim g idance for the
rin LMWH been associated ith poor decreased mortalit hen gi en proph management of COVID- -associated
nfractionat o tcomes e g progressi e lactic doses of LMWH or UFH Ho e er coag lopath
ed heparin respirator fail re ac te prospecti e st dies are needed to confirm
UFH respirator distress s n these findings The International Societ for Thrombosis
drome ARDS death - and Haemostasis ISTH and the American
Updated A randomi ed open-label clinical trial Societ of Hematolog ASH recommend
Coag lation abnormalities NCT is c rrentl being cond ct that all hospitali ed COVID- patients
obser ed in these patients ed to e al ate proph lactic- and therape incl ding non-ICU patients recei e
incl de prothrombotic dis tic-dose anticoag lation in hospitali ed proph lactic-dose LMWH nless contrain
seminated intra asc lar ad lts ith se ere COVID- infection dicated e g acti e bleeding platelet
coag lation DIC eno s co nt L fibrinogen less than
thromboembolism ele ated gL Abnormal PT or aPTT is not a
contraindication for proph la is
D-dimer le els high fibrino WHO recommends pharmacologic
gen le els and micro asc proph la is ith LMWH preferred or
lar and macro asc lar UFH nits s b-Q t ice dail in
thrombosis - ad lts and adolescents itho t contra
indications
Earl anticoag lation in
Altho gh LMWH is generall preferred
patients ith se ere COVID-
UFH also has been sed for throm
infection ma red ce the boproph la is practical concerns e g
risk of thrombotic complica need for freq ent monitoring con en
tions and impro e clinical ience of administration risk of medical
o tcomes staff e pos re ma infl ence instit
tional choice of anticoag lant
An additional benefit of
heparins is their anti- Beca se of the se erit of coag lopath
inflammator effects in criticall -ill COVID- patients and
reports of thrombotic complications
that ha e contin ed to occ r despite
standard proph la is ith LMWH or
UFH some clinicians s ggest that higher
proph lactic doses or e en therape tic
doses be considered ho e er high-
q alit randomi ed controlled st dies
are needed to e al ate these approach
es
The American Societ of Hematolog

ASH states that therape tic anticoag
lation is not req ired in COVID- pa
tients nless there is doc mented VTE
or atrial fibrillation The efficac of
intermediate or f ll therape tic antico
ag lation for criticall ill COVID- pa
tients itho t doc mented VTE is being
e al ated In patients alread on anti
coag lation for VTE or atrial fibrillation
therape tic doses of anticoag lant ther
ap sho ld contin e b t ma need to be
held if the platelet co nt is less than -
L or if fibrinogen is less than
gL
The risk of eno s thromboembolism

and anticoag lation req irements
sho ld be assessed in all patients on an
indi id al basis
Bleeding appears to be infreq ent in

COVID- patients Ho e er standard
risk factors for bleeding sho ld be con
sidered and patients sho ld be indi id
all assessed to balance risk of throm
bosis ith risk of bleeding
Famotidine Comp ter-aided str ct re- C rrentl no kno n p blished clinical trial Dosage in NCT Famotidine Safet and efficac for treatment of
Histamine H based irt al screening of e idence s pporting efficac or safet for is being gi en IV in -mg doses COVID- not established
Added Antagonists libraries of compo nds treatment of COVID- proposed total dail dosage of
against SARS-CoV- pro mg for ma im m of da s
teins s ggested potential Randomi ed do ble-blind historical- or ntil hospital discharge hiche er
for famotidine to interact controlled comparati e trial comes first
ith iral proteases in NCT initiated in Ne York in
ol ed in corona ir s repli hospitali ed ad lts ith moderate to se Proposed dail dosage in
cation - ere COVID- trial incl des acti e treat NCT is times the s al
ment gro ps high-dose IV famotidine ith man fact rer-recommended IV ad lt
Anecdotal obser ations oral h dro chloroq ine IV placebo ith dosage the st d e cl des pa
incl ding obser ations oral h dro chloroq ine and a historical tients ith creatinine clearance Clcr)
based on retrospecti e control gro p recei ing neither of these 50 mL min te incl ding dial sis
medical record re ie dr gs patients treated d ring earl stages patients renall impaired patients
indicated that man Chi of the COVID- pandemic in Ne York ma be at increased risk of ad erse
nese COVID- s r i ors targeted enrollment is patients in each CNS effects since dr g half-life is
had recei ed famotidine acti e treatment gro p interim anal ses closel related to Clcr
for chronic heartb rn planned
mortalit rate appeared to
be lo er in hospitali ed
COVID- patients recei
ing famotidine than in
patients not recei ing the
dr g s obser a
tions did not control for
possible confo nding e g
socioeconomic factors
HMG-CoA Antilipe In addition to lipid- Data are lacking on the se of statins in NIH COVID- Treatment G idelines
Red ctase mic Agents lo ering effects statins patients ith COVID- Panel states patients ho are recei ing
Inhibitors ha e anti-inflammator a statin for the treatment or pre ention
statins and imm nomod lator Preliminar findings ha e sho n mi ed of cardio asc lar disease sho ld contin
effects hich ma pre ent res lts ith other respirator illnesses e statin therap recommends against
Added ac te l ng inj r some obser ational st dies s ggest statin se of statins for the treatment of
therap is associated ith a red ction in COVID- e cept in the conte t of a
Statins affect ACE as part ario s cardio asc lar o tcomes and possi clinical trial
of their f nction in red c bl mortalit in patients hospitali ed ith
ing endothelial d sf nc infl en a and or pne monia - Patients ith cardio asc lar disease are
tion at an increased risk of serio s COVID-
Clinical trials are e al ating the effecti e infections
ness of statins ith and itho t other
potential treatment agents for the treat In patients ith acti e COVID- ho
ment of COVID- NCT ma de elop se ere rhabdom ol sis it
NCT ma be ad isable to ithhold statin
therap for a short period of time
Most statins are s bstrates for the

CYP s stem potential for dr g inter
actions
Clinicians sho ld ens re that their high-
risk primar pre ention for ASCVD
patients are on g ideline-directed statin
therap
Imm ne Commerciall a ailable SARS Experience: IGIV has been sed in IGIV dosage of - g kg dail for Role of commerciall a ailable imm ne
Glob lin Imm ne imm ne glob lin IGIV some pts for the treatment of SARS - da s has been sed in some pts glob lin IGIV IVIG γ-glob lin in the
IGIV IVIG Glob lin IVIG γ-glob lin is deri ed Benefits in s ch pts ere nclear beca se ith COVID- IGIV dosage of treatment of COVID- nclear
γ-glob lin from pooled plasma con of comorbidities differences in stage of g kg dail for da s being in esti
tains man antibodies nor illness and effect of other treatments gated in a clinical trial in China The S r i ing Sepsis Campaign COVID-
Added mall present in ad lt h IGIV ma ha e contrib ted to h percoag s bcommittee s ggests that IGIV not
man blood sed for re lable state and thrombotic complications in be sed ro tinel in criticall ill ad lts
placement therap in pts some pts ith COVID- beca se efficac data
ith primar h moral im not a ailable c rrentl a ailable IGIV
m nodeficienc nable to COVID- case reports in China (Cao et al): preparations ma not contain antibod
prod ce s fficient IgG anti Treatment ith IGIV at the earl stage of ies against SARS-CoV- and IGIV can be
bodies and also sed to clinical deterioration as reported to pro associated ith increased risk of se ere
pro ide passi e imm nit ide some clinical benefit in ad lts ith ad erse effects e g anaph la is asep
to certain iral infections in se ere COVID- pts also recei ed anti i tic meningitis renal fail re thrombo
other indi id als rals and pt also recei ed short-term ster embolism hemol tic reactions transf
oid treatment Patients ere afebrile ith sion-related l ng inj r
Ma mod late imm ne in - da s and breathing diffic lties grad
responses to infections all impro ed ithin - da s of IGIV ad IGIV mentioned in Chinese g idelines as
ministration other therape tic meas re for treat
Commerciall a ailable ment of se ere and critical cases of
preparations of imm ne COVID- clinical experience in China: IGIV COVID- in children
glob lin IGIV IVIG γ- has been sed as an adj nct in the treat
-
glob lin ma contain anti ment of COVID-
bodies against some pre i
o sl circ lating corona Efficacy data not available from controlled
ir ses ho e er de clinical studies to date.
pending on time of donor
plasma collection s ch COVID- clinical trial in China
preparations ma not con (NCT ): Open-label randomi ed
tain antibodies against trial initiated to e al ate efficac and safet
SARS-CoV- of IGIV ith standard care for treatment of
se ere COVID-
I ermectin In itro acti it against C rrentl no kno n p blished data regard No data to date to s pport se in the
Anthelmintic some h man and animal ing efficac or safet in the treatment of treatment of COVID-
Updated ir ses - COVID- I ermectin plasma concentrations
attained ith dosages recommended
In itro e idence of acti it for treatment of parasitic infections are
against SARS-CoV- in in s bstantiall lo er than concentrations
fected Vero-hSLAM cells associated ith in itro inhibition of
reported ith high concen SARS-CoV-
trations of the dr g
FDA iss ed a arning concerning possi
ble inappropriate se of i ermectin
prod cts intended for animals as an
attempt to self-medicate for the treat
ment of COVID-
Neb li ed Potential harm: Concern Neb li er treatment sed in clinical prac American College of Allerg Asthma
dr gs that se of neb li ed dr gs tice to treat infl en a and other respirato Imm nolog ACAAI recommends that
e g alb terol for the man r infections is tho ght to generate drop neb li ed alb terol sho ld be adminis
Added agement of respirator con lets or aerosols In one st d neb li ed tered in a location that minimi es e po
ditions in patients ith saline deli ered droplets in the small- and s re to close contacts ho do not ha e
COVID- infection ma medi m-si e aerosol droplet range These COVID- infection In the home
distrib te the ir s into the res lts ma ha e infection control implica choose a location here air is not recir
air and e pose close con tions for airborne infections incl ding c lated e g porch patio or garage or
tacts se ere ac te respirator s ndrome and areas here s rfaces can be cleaned
pandemic infl en a infection easil or ma not need cleaning
In hospitals clinicians t picall se neb

li ers to deli er medications s ch as
alb terol b t are being enco raged to
s itch to se of metered-dose inhalers
beca se of the risk of the ir s becom
ing airborne hen treating patients
infected ith COVID-
Niclosamide Broad anti iral acti it C rrentl no kno n p blished clinical trial Not commerciall a ailable in the US
Anthelmintic data regarding efficac or safet in the
In itro e idence of acti it treatment of COVID- No data to date s pport se in treat
against SARS-CoV and MERS ment of COVID-
-CoV In dr g rep rposing screens as fo nd to
inhibit replication and antigen s nthesis of
SARS-CoV did not interfere ith irion’s
attachment into cells
Nita o anide In itro acti it against ari C rrentl no kno n p blished clinical trial Dosages investigated for treatment C rrent data not specific to COVID-
Antiproto oal o s ir ses incl ding coro data regarding efficac or safet in the of influenza and influenza-like ill- additional st d needed
Updated na ir ses treatment of COVID- ness or being investigated for other
viral infections: Ad lts and adoles
Str ct rall similar to niclos Experience in treating influenza: In a ran cents ( 12 ears of age or
amide domi ed placebo-controlled st d in mg orall t ice dail for da s
other ise health ad lt and adolescent
In itro e idence of acti it patients ith ac te ncomplicated infl en Protocol in one ongoing trial
against SARS-CoV- a treatment ith nita o anide red ced NCT for treatment of
d ration of s mptoms b appro imatel moderate COVID- specifies a nita
In itro acti it against da o anide dosage of mg t ice
MERS-CoV dail for da s
Experience in treating influenza-like ill-
S ppresses prod ction of ness: In t o st dies for the treatment of Protocol in t o ongoing trials
proinflammator c tokines infl en a-like illness s mptoms associated NCT NCT e al
in peripheral blood mono ith iral respirator infection in ating pre- and or post-e pos re
n clear cells s ppresses IL- ad lts and pediatric pts treatment ith proph la is of COVID- and other
in mice nita o anide red ced d ration of s mp iral respirator illnesses specifies a
toms da s ers s da s ith placebo nita o anide dosage of mg orall
In another st d in ad lts and pediat t ice dail for eeks
ric pts hospitali ed ith infl en a-like
illness ( 50 ith pne monia at presenta

tion treatment ith nita o anide did not
red ce the d ration of hospital sta
primar end point or d ration of s mp
toms
COVID- Randomi ed do ble-blind

placebo-controlled proof-of-concept trial
NCT initiated to e al ate nita
o anide for treatment of moderate COVID
-
Two randomized, double-blind, placebo-

controlled clinical trials ha e been initiat
ed b the man fact rer Romark to e al
ate efficac and safet for pre- or post-
e pos re proph la is of COVID- and
other iral respirator illnesses in
healthcare orkers NCT and
post-e pos re proph la is of COVID- and
other iral respirator illnesses in elderl
residents of long-term care facilities
NCT
Multiple other clinical trials planned or

initiated to e al ate nita o anide in com
bination ith other dr gs chloroq ine
h dro chloroq ine or i ermectin or
alone for treatment of COVID-
Nonsteroidal Ibuprofen: Spec lati e link Ibuprofen: None anecdotal Ibuprofen: A letter p blished in The
Anti- Nonsteroidal bet een ib profen and Lancet Respir Med stated that increased
inflammator Anti- increased ACE e pression Indomethacin: Spec lati e one in vitro & e pression of ACE co ld facilitate in
Agents inflammator leading to worse out- animal model st d ith other corona fection ith COVID- The letter states
NSAIAs Agent NSAIA comes in COVID- pa ir ses SARS-CoV CanineCoV that thia olidinediones and ib profen
tients and sho ld NOT be can increase ACE ho e er this ap
Updated sed in patients ith pears to be based on animal st dies
COVID-
A statement attrib ted to WHO spokes
Indomethacin: Possible person Christian Lindmeier recommend
anti iral acti it against ing paracetamol and a oiding ib profen
other corona ir ses SARS- as a self-medication as idel circ lat
CoV CanineCoV ed in the media ho e er s ch a posi
interferes ith iral RNA tion co ld not be fo nd on the WHO
s nthesis ebsite or other official so rces WHO
has stated after a rapid re ie of the
literat re is not a are of p blished
clinical or pop lation-based data on this
topic As of ia T itter) “WHO

does not recommend against the se of
ib profen ” https t itter com WHO
stat s
In addition there ha e been ns bstan

tiated reports of o nger health pa
tients ho took ib profen and s ffered
se ere o tcomes ith COVID- Official
case reports are lacking
On FDA iss ed a statement

that it is not a are of scientific e idence
connecting the se of NSAIAs s ch as
ib profen ith orsening COVID-
s mptoms FDA stated that it is in esti
gating this iss e f rther and ill com
m nicate p blicl hen more infor
mation is a ailable FDA also noted that
all prescription NSAIA labels arn that
b red cing inflammation and possibl
fe er these dr gs ma diminish the
tilit of diagnostic signs in detecting
infections https fda go dr gs
dr g-safet -and-a ailabilit fda-ad ises-
patients- se-non-steroidal-anti-
inflammator -dr gs-nsaids-co id-
Therefore c rrentl no compelling e i

dence to s pport an association be
t een ib profen and negati e o t
comes in patients ith COVID- How-
ever, some experts have recommended
preferentially using acetaminophen for
treatment of fever , ,
NIH COVID- Treatment G idelines

Panel states that patients ho are re
cei ing NSAIAs for other conditions
sho ld contin e recei ing the dr gs
states antip retic strateg e g se of
acetaminophen or NSAIAs sho ld be no
different bet een patients ith or ith
o t COVID-
The S r i ing Sepsis Campaign COVID-

g idelines state that ntil more e i
dence is a ailable se of acetamino
phen o er no treatment for fe er con
trol is s ggested eak recommenda
tion
Tiss e Plas A consistent finding in Res lts of a small phase st d cond cted The open-label s stemic fibrinol tic t-PA has been proposed as a sal age
minogen Acti Thrombol tic patients ith se ere COVID in s ggest possible benefit of plasmin therap trial NCT ill treatment for COVID- patients e g
ator t-PA agents - is a h percoag lable ogen acti ators for the treatment of ARDS e al ate t-PA alteplase dosages of those ith decompensating respirator
-
alteplase state hich ma contrib In this st d patients ith ARDS sec mg administered as a -mg IV f nction ho do not ha e access to
te to their risk of poor ondar to tra ma and or sepsis ho failed bol s follo ed b IV administration mechanical entilation or e tracorpore
Updated o tcomes e g progres to respond to standard entilator therap of the remaining mg o er a total al membrane o genation ECMO
si e respirator fail re and ere not e pected to s r i e ere time of ho rs and mg Ho e er there are c rrentl no clini
ac te respirator distress treated ith rokinase or streptokinase administered as a -mg IV bol s cal trial data to inform this practice and
s ndrome ARDS death - s ch therap impro ed PaO and also ap dose follo ed b IV administration a lack of clinical e perience ith the se
-
peared to impro e s r i al - of the remaining mg o er a total of fibrinol tic agents in ARDS patients in
A registered open-label randomi ed trial time of ho rs a heparin inf sion general
Coag lation abnormalities NCT ill e al ate s stemic fibri ill be initiated immediatel follo
obser ed in these patients nol tic therap ith t-PA ers s standard ing completion of the alteplase inf Se eral instit tions Beth Israel Deacon
incl de prothrombotic of care in mechanicall entilated COVID- sion ess Uni ersit of Colorado Ansch lt
disseminated intra asc lar patients ith se ere respirator fail re Medical Camp s Den er Health are
coag lation DIC a high Other dosage regimens ha e been c rrentl testing the se of t-PA as sal
incidence of eno s throm A registered open-label nonrandomi ed e al ated in patients ith ARDS age therap in patients ith se ere
boembolism ele ated D- pilot st d NCT ill e al ate an associated ith COVID- incl ding COVID- nder the FDA compassion
dimer le els high fibrino inhaled form lation of t-PA ia neb li a an initial t-PA alteplase dose of ate se program Preliminar find
gen le els and micro asc tion in patients ith ARDS d e to COVID- mg administered IV o er ho rs ings from the first fe cases reported an
lar and macro asc lar the inhaled form lation of t-PA is follo ed b an IV inf sion of initial b t transient impro ement in
-
thrombosis in estigational at this time mg of t-PA o er the s bseq ent PaO FiO P F ratio
ho rs ith a dose not to e ceed
In patients ith ARDS mg kg Beth Israel Deaconess et The American Societ of Hematolog
regardless of the ca se al st d ho e er the optim m states that treatment of the nderl ing
pathologic findings incl de dose ro te of administration and patholog is paramo nt in COVID-
fibrin deposition in the d ration of treatment remain to be patients ith coag lopathies s p
al eoli and formation of determined porti e care sho ld be indi id ali ed
microthrombi in the p l and standard risk factors for bleeding
monar asc lat re sho ld be considered
Treatment ith t-PA ma
restore micro asc lar pa
tenc and limit progression
of ARDS in patients ith
COVID-
a See US prescribing information for additional information on dosage and administration of drugs commercially available in the US for other labeled indications.
REFERENCES
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HFSA ACC AHA statement addresses concerns re sing RAAS antagonists in co id- From American College of Cardiolog ebsite Accessed Mar A ailable from https
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Position statement of the ESC co ncil on h pertension on ACE-inhibitors and angiotensin receptor blockers From E ropean Societ of Cardiolog ebsite Accessed Mar A ailable
from https escardio org Co ncils Co ncil-on-H pertension- CHT Ne s position-statement-of-the-esc-co ncil-on-h pertension-on-ace-inhibitors-and-ang
Zheng Y Ma Y Zhang J et al COVID- and the cardio asc lar s stem Nat Re Cardiol PMID DOI s - - -
L R Li J Genomic characterisation and epidemiolog of no el corona ir s implications for ir s origins and receptor Lancet - PMID DOI S -
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Chloroquine and Hydroxychloroquine:

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Gao J Tian Z Yang X Breakthro gh Chloroq ine phosphate has sho n apparent efficac in treatment of COVID- associated pne monia in clinical st dies Biosci Trends -
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US Food and Dr g Administration Letter of a thori ation Emergenc se a thori ation for se of chloroq ine phosphate or h dro chloroq ine s lfate s pplied from the strategic national
stockpile for treatment of Corona ir s disease Mar From FDA ebsite https fda go media do nload
US Food and Dr g Administration Fact sheet for health care pro iders emergenc se a thori ation EUA of chloroq ine phosphate s pplied from the strategic national stockpile for treat
ment of COVID- in certain hospitali ed patients Dated Mar From FDA ebsite https fda go media do nload
US Food and Dr g Administration Fact sheet for health care pro iders emergenc se a thori ation EUA of h dro chloroq ine s lfate s pplied from the strategic national stockpile for
treatment of COVID- in certain hospitali ed patients Dated Mar From FDA ebsite https fda go media do nload
US Food and Dr g Administration Fact sheet for patients and parent caregi ers emergenc se a thori ation EUA of chloroq ine phosphate for treatment of COVID- in certain hospital
i ed patients Dated Mar From FDA ebsite https fda go media do nload
US Food and Dr g Administration Fact sheet for patients and parent caregi ers emergenc se a thori ation EUA of h dro chloroq ine s lfate for treatment of COVID- in certain hospi
tali ed patients Dated Mar From FDA ebsite https fda go media do nload
US Department of Health and H man Ser ices HHS HHS accepts donations of medicine to strategic national stockpile as possible treatments for COVID- patients March From
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COVID- infection Med Mal Infect Mar Ep b PMID DOI j medmal
Ga tret P Lagier JC Parola P et al Clinical and microbiological effect of a combination of h dro chloroq ine and a ithrom cin in COVID- patients ith at least a si -da follo p a
pilot obser ational st d Tra el Med Infect Dis Apr Ep b PMID DOI j tmaid
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d e to risk of heart rh thm problems April A ailable at https fda go media do nload
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Corticosteroids, including methylprednisolone:

World Health Organi ation Clinical management of se ere ac te respirator infection SARI hen COVID- disease is s spected Interim g idance Mar From WHO ebsite Ac
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CD p b PMID
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COVID- Convalescent Plasma:

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Mair-Jenkins J Saa edra-Compos M Baillie JK et al The effecti eness of con alescent plasma and h perimm ne imm noglob lin for the treatment of se ere ac te respirator infections of
iral etiolog a s stematic re ie and e plorator meta-anal sis J Infect Dis - PMID DOI infdis ji
Cheng Y Wong R Soo YOY et al Use of con alescent plasma therap in SARS patients in Hong Kong E r J Clin Microbiol Infect Dis - PMID DOI s - -
-
Soo YOY Cheng Y Wong R Retrospecti e comparison of con alescent plasma ith contin ing high-dose meth lprednisolone treatment in SARS patients Clin Microbiol Infect -
PMID DOI j -
D an K Li B Li C et al Effecti eness of con alescent plasma therap in se ere COVID- patients Proc Natl Acad Sci USA Apr Ep b https pnas org cgi doi
pnas PMID DOI pnas
Shen C Wang Z Zhao F et al Treatment of criticall ill patients ith COVID- ith con alescent plasma JAMA Mar Ep b PMID DOI jama
US Department of Health and H man Ser ice Food and Dr g Administration Center for Biologics E al ation and Research In estigational COVID- con alescent plasma g idance for ind s
tr April pdated April From FDA ebsite Accessed Apr https fda go media do nload
Ma o Clinic E panded access to con alescent plasma for the treatment of patients ith COVID- From Ma o Clinic ebsite https sco idplasma org
Yeh KM Chi eh TZ Si LK et al E perience of sing con alescent plasma for se ere ac te respirator s ndrome among healthcare orkers in a Tai an hospital J Antimicrob Chemother
- PMID DOI jac dki
AABB COVID- con alescent plasma collection Donor eligibilit processing labeling and distrib tion Dated Apr From aabb ebsite http aabb org
American Red Cross Corona ir s COVID- con alescent plasma clinician information From American Red Cross ebsite Accessed Apr https redcrossblood org donate-
blood dlp plasma-donations-from-reco ered-co id- -patients clinician-registration html
Epoprostenol:
Alessandri F P gliese F Ranieri VM The Role of Resc e Therapies in the Treatment of Se ere ARDS Respir Care - P bmed DOI respcare
Cherian SV K mar A Akasap K Sal age therapies for refractor h po emia in ARDS Respir Med - P bmed DOI j rmed
Tamb rro RF Kne ber MC Pediatric Ac te L ng Inj r Consens s Conference Gro p P lmonar specific ancillar treatment for pediatric ac te respirator distress s ndrome proceedings
from the Pediatric Ac te L ng Inj r Consens s Conference Pediatr Crit Care Med S ppl S - P bmed DOI PCC
Walmrath D Schneider T Pilch J Aerosolised prostac clin in ad lt respirator distress s ndrome Lancet - P bmed DOI - -d
Ammar MA Ba er SR Bass SN Noninferiorit of Inhaled Epoprostenol to Inhaled Nitric O ide for the Treatment of ARDS Ann Pharmacother - P bmed DOI
Afshari A Bastholm Bille A Allingstr p M Aerosoli ed prostac clins for ac te respirator distress s ndrome ARDS Cochrane Database S st Re CD P bmed
DOI CD p b
Dahlem P an Aalderen WM de Neef M Randomi ed controlled trial of aerosoli ed prostac clin therap in children ith ac te l ng inj r Crit Care Med - P bmed
DOI ccm bf
F ller BM Mohr NM Skr pk L The se of inhaled prostaglandins in patients ith ARDS a s stematic re ie and meta-anal sis Chest - P bmed DOI
chest -
Searc RJ Morales JR Ferreira JA et al The role of inhaled prostac clin in treating ac te respirator distress s ndrome Ther Ad Respir Dis - P bmed DOI
Alha ani W Moller MH Arabi YM et al S r i ing Sepsis Campaign G idelines on the Management of Criticall Ill Ad lts ith Corona ir s Disease COVID- Crit Care Med
PMID DOI CCM
Famotidine:
W C Li Y Yang Y et al Anal sis of therape tic targets for SARS-CoV- and disco er of potential dr gs b comp tational methods Acta Pharm Sin B Preproof PMID DOI
j apsb
Dong S S n J Mao Z et al A g ideline for homolog modeling of the proteins from ne l disco ered betacorona ir s no el corona ir s -nCoV J Med Virol PMID
DOI jm
Borrell B Ne York clinical trial q ietl tests heartb rn remed against corona ir s Science Apr From Science maga ine ebsite https sciencemag org ne s ne -
ork-clinical-trial-q ietl -tests-heartb rn-remed -against-corona ir s
Pillai ar T Manickam M Namasi a am V et al An o er ie of se ere ac te respirator s ndrome-corona ir s SARS-CoV CL protease inhibitors peptidomimetics and small molec le
chemotherap J Med Chem - PMID DOI acs jmedchem b
Freseni s Kabi Famotidine injection prescribing information Lake Z rich IL Sep
Favipiravir
Wang M Cao R Zhang L et al Remdesi ir and chloroq ine effecti el inhibit the recentl emerged no el corona ir s -nCoV in itro Cell Res 2020;30:26 2 1. PMID DOI
s - - -
Dong L H S Gao J Disco ering dr gs to treat corona ir s disease COVID- Dr g Disco Ther 2020;14:5 60. PMID DOI ddt
Li G De Clercq E Therape tic options for the no el corona ir s -nCoV Nat Re Dr g Disco 2020;1 :14 150. PMID DOI d - - -
De Clercq E Ne n cleoside analog es for the treatment of hemorrhagic fe er ir s infections Chem Asian J 201 ;14:3 62 3 6 . PMID DOI asia
McCrear EK Pog e M on behalf of the Societ of Infectio s Diseases Pharmacists COVID- Treatment a re ie of earl and emerging options Open For m Infectio s Diseases ofaa
DOI ofid ofaa
Chen C H ang J Cheng Z et al Fa ipira ir ers s arbidol for COVID- a randomi ed clinical trial medR i DOI
U S National Librar of Medicine ClinicalTrials go Accessed Apr A ailable at http clinicaltrials go
Chinese Clinical Trial Registr Accessed Apr A ailable at http chictr org cn
NIPH Clinical Trials Search NIPH Clinical Trials Search of Japan Accessed Apr A ailable at https rctportal niph go jp en
McGrane V Massach setts to la nch first US trial of Japanese corona ir s dr g Boston Globe Updated Apr Accessed Apr A ailable at https
bostonglobe com metro massach setts-la nch-first-trial-japanese-co id-dr g
Sanders JM Monog e ML Jodlo ski TZ et al Pharmacologic treatments for Corona ir s disease COVID- a re ie JAMA PMID DOI jama
Mentré F Tab ret AM G edj J et al Dose regimen of fa ipira ir for Ebola ir s disease Lancet Infect Dis - PMID DOI S - -
Sissoko D Lao enan C Folkesson E et al E perimental treatment ith fa ipira ir for Ebola ir s disease the JIKI Trial a historicall controlled single-arm proof-of-concept trial in G inea
PLoS Med e PMID DOI jo rnal pmed
Taisho To ama Pharmace tical Co Ltd A igan fa ipira ir tablets prescribing information English translation Tok o Japan No Accessed Apr A ailable at https
cdc go t File Get ht jUiB MI-aKnl st
Cai Q Yang M Li D et al E perimental treatment ith fa ipira ir for COVID- an open-label control st d Engineering DOI j eng
Cho KT Wong AY Kae preedee P et al Remdesi ir lopina ir emetine and homoharringtonine inhibit SARS-CoV- replication in itro Anti iral Res PMID
DOI j anti iral
D YX Chen XP Fa ipira ir Pharmacokinetics and concerns abo t clinical trials for -nCoV infection Clin Pharmacol Ther PMID DOI cpt
Zhao Y Harmat JS Epstein CR et al Fa ipira ir inhibits acetaminophen s lfate formation b t minimall affects s stemic pharmacokinetics of acetaminophen Br J Clin Pharmacol
- PMID DOI bcp
HIV Protease Inhibitors:

Ch CM Cheng VC H ng IF et al Role of lopina ir ritona ir in the treatment of SARS initial irological and clinical findings Thora - P bMed DOI
thora
Chen F Chan KH Jiang Y et al In itro s sceptibilit of clinical isolates of SARS corona ir s to selected anti iral compo nds J Clin Virol - P bMed DOI
j jc
Cao B Wang Y Wen D et al A Trial of Lopina ir-Ritona ir in Ad lts Hospitali ed ith Se ere Co id- N Engl J Med P bMed DOI NEJMoa
Arabi YM Alothman A Balkh HH et al Treatment of Middle East Respirator S ndrome ith a combination of lopina ir-ritona ir and interferon-β1b MIRACLE trial st d protocol for a
randomi ed controlled trial Trials P bMed DOI s - - -
Li F X A Zhang Y et al Patients of COVID- ma benefit from s stained lopina ir-combined regimen and the increase of eosinophil ma predict the o tcome of COVID- progression Int J
Infect Dis P bMed DOI j ijid
Deng L Li C Zeng Q et al Arbidol combined ith LPV r ers s LPV r alone against Corona Vir s Disease a retrospecti e cohort st d J Infect IDIS P bMed DOI
j jinf URL
Chan JF Yao Y Ye ng ML et al Treatment With Lopina ir Ritona ir or Interferon-β1b Impro es O tcome of MERS-CoV Infection in a Nonh man Primate Model of Common Marmoset J In
fect Dis - IDIS P bMed DOI infdis ji URL
Kim UJ Won EJ Kee SJ et al Combination therap ith lopina ir ritona ir riba irin and interferon-α for Middle East respirator s ndrome Anti ir Ther - P bMed
DOI IMP
Yao TT Qian JD Zh WY et al A s stematic re ie of lopina ir therap for SARS corona ir s and MERS corona ir s-A possible reference for corona ir s disease- treatment option J Med
Virol P bMed DOI jm
L H Dr g treatment options for the -ne corona ir s -nCoV Biosci Trends - P bMed DOI bst
Martine MA Compo nds ith therape tic potential against no el respirator corona ir s Antimicrob Agents Chemother P bMed DOI AAC -
Yo ng BE Ong SWX Kalim ddin S et al Epidemiologic Feat res and Clinical Co rse of Patients Infected With SARS-CoV- in Singapore JAMA P bMed DOI
jama
National Health Commission NHC State Administration of Traditional Chinese Medicine Trial Version Diagnosis and treatment protocol for no el corona ir s pne monia URL http
b san china-cons late org chn t P pdf
Zho F Y T D R et al Clinical co rse and risk factors for mortalit of ad lt inpatients ith COVID- in W han China a retrospecti e cohort st d Lancet P bMed DOI
S - -
Lim J Jeon S Shin HY et al Case of the inde patient ho ca sed tertiar transmission of corona ir s disease in Korea the application of lopina ir ritona ir for the treatment of COVID-
pne monia monitored b q antitati e RT-PCR J Korean Med Sci e DOI jkms e
Fintelman-Rodrig es N Sacramento CQ Lima CR et al Ata ana ir inhibits SARS-CoV- replication and pro-inflammator c tokine prod ction Preprint DOI
De Me er S Bojko a D Cinati J et al Lack of anti iral acti it of Dar na ir against SARS-CoV- Preprint DOI
Yamamoto N Mats am S Hoshino T et al Nelfina ir inhibits replication of se ere ac te respirator s ndrome corona ir s in itro Preprint DOI
Chinese Clinical Trial Registr ChiCTR Accessed Apr A ailable at http chictr org cn
Johnson Johnson Lack of e idence to s pport se of dar na ir-based treatments for SARS-CoV- From Johnson Johnson ebsite Accessed Apr A ailable at https
jnj com lack-of-e idence-to-s pport-dar na ir-based-hi -treatments-for-corona ir s
HMG-CoA Reductase Inhibitors (statins)

Phadke M Sa nik S COVID- treatment b rep rposing dr gs ntil the accine is in sight Dr g De Res PMID DOI ddr
Is there a role for statin therap in ac te iral infections From JACC ebsite Accessed Apr A ailable from https acc org latest-in-cardiolog articles is-
there-a-role-for-statin-therap -in-ac te- iral-infections-co id-
Frost FJ Petersen H Tollestr p K et al Infl en a and COPD mortalit protection as pleiotropic dose-dependent effects of statins Chest - PMID DOI
chest -
Do glas I E ans S Smeeth L Effect of statin treatment on short term mortalit after pne monia episode cohort st d BMJ d PMID DOI bmj d
Vandermeer ML Thomas AR Kamimoto L et al Association bet een se of statins and mortalit among patients hospitali ed ith laborator -confirmed infl en a ir s infections a m lti
state st d J Infect Dis - PMID DOI infdis jir
Dashti-Kha idaki S Khalili H Considerations for statin therap in patients ith COVID- Pharmacotherap PMID DOI phar
Fedson DS Opal SM Rordam OM Hiding in plain sight an approach to treating patients ith se ere COVID- infection mBio PMID DOI mBio -
U S National Librar of Medicine ClinicalTrials go Accessed Apr A ailable from https clinicaltrials go ct sho NCT term statins cond co id dra rank
NLM identifier NCT
U S National Librar of Medicine ClinicalTrials go Accessed Apr A ailable from https clinicaltrials go ct sho NCT term statins cond co id dra rank
NLM identifier NCT
Immune Globulin (IGIV, IVIG, γ-globulin):

AHFS dr g information Sno EK ed Imm ne Glob lin Bethesda MD American Societ of Health-S stem Pharmacists - https ahfscdi com dr gs
Ja hara S Co ld intra eno s imm noglob lin collected from reco ered corona ir s patients protect against COVID- and strengthen the imm ne s stem of ne patients Int J Mol Sci
http d doi org ijms PMID DOI ijms
Sanders JM Monog e ML Jodlo ski et al Pharmacologic treatments for corona ir s diseases COVID- a re ie JAMA Ep b PMID DOI jama
Chiang CH Chen HM Shih JF et al Management of hospital-acq ired se ere ac te respirator s ndrome ith difference disease spectr m J Chin Med Assoc - PMID
Stockman LJ Bellam R Garner P SARS S stemic re ie of treatment effects PLoS Med e PMID DOI jo rnal pmed
Umapathi T Kor AC Venketas bramanian N et al Large arter ischaemic stroke in se ere ac te respirator s ndrome SARS J Ne rol - PMID DOI
s - - -
Ng KHL W AKL Cheng VCC et al P lmonar arter thrombosis in a patient ith se ere ac te respirator s ndrome Postgrad Med J e PMID
Cao W Li X Bai T et al High-dose intra eno s imm noglob lin as a therape tic option for deteriorating patients ith corona ir s disease Open For m Infectio s Diseases PMID
DOI ofid ofaa
Chen N Zho M Dong X et al Epidemiological and clinical characteristics of cases of no el corona ir s pne monia in W han China a descripti e st d Lancet -
PMID DOI S - -
Yang X Y an Y Z J et al Clinical co rse and o tcomes of criticall ill patients ith SARS-CoV- pne monia in W han China a single-centered retrospecti e obser ational st d Lancet
Respir Med Ep b https doi org S - - PMID
G an W Ni Z H Y et al Clinical characteristics of corona ir s disease in China N Engl J Med Ep b PMID DOI NEJMoa
U S National Librar of Medicine ClinicalTrials go Accessed Apr A ailable from https clinicaltrials go ct sho NCT
Alha ani W Møller MH Arabi YM et al S r i ing sepsis campaign G idelines on the management of criticall ill ad lts ith corona ir s disease COVID- Crit Care Med
PMID DOI CCM
National Health Commission NHC State Administration of Traditional Chinese Medicine Trial Version Diagnosis and treatment protocol for no el corona ir s pne monia
Wang JT Sheng WH Fang CT Clinical manifestations laborator findings and treatment o tcomes of SARS patients Emerg Infect Dis - PMID DOI
eid
Ivermectin:
Cal L Dr ce JD Catton MG et al The FDA-appro ed dr g i ermectin inhibits the replication of SARS-CoV- in itro Anti iral Res Preprint https sciencedirect com science
article pii S ia Dih b
Mastrangelo E Pe llo M De B rghgrae e T et al I ermectin is a potent inhibitor of fla i ir s replication specificall targeting NS helicase acti it ne prospects for an old dr g J Antimi
crob Chemother - PMID DOI jac dks
Yang SNY Atkinson SC Wang C et al The broad spectr m anti iral i ermectin targets the host n clear transport importin α/β1 heterodimer Anti iral Res PMID DOI
j anti iral
Varghese FS Ka kinen P Glasker S et al Disco er of berberine abamectin and i ermectin as anti irals against chik ng n a and other alpha ir ses Anti iral Res - PMID
DOI j anti iral
A eem S Ashraf M Rasheed MA et al E al ation of c toto icit and anti iral acti it of i ermectin against Ne castle disease ir s Pak J Pharm Sci - PMID
Ta MY Fraser JE Chan WK et al N clear locali ation of deng e ir s DENV - non-str ct ral protein protection against all DENV serot pes b the inhibitor i ermectin Anti iral Res
- PMID DOI j anti iral
Momeko G Momeko a D I ermectin as a potential COVID- treatment from the pharmacokinetic point of ie Preprint https doi org DOI
US Food and Dr g Administration FDA letter to stakeholders do not se i ermectin intended for animals as treatment for COVID- in h mans April From FDA ebsite https
fda go animal- eterinar prod ct-safet -information fda-letter-stakeholders-do-not- se-i ermectin-intended-animals-treatment-co id- -h mans
Nebulized drugs:
American College of Allerg Asthma Imm nolog COVID- and asthma What o need to kno mo ing for ard From ACAAI ebsite Accessed Mar A ailable from https
acaai org ne s co id- -and-asthma- hat- o -need-kno -mo ing-for ard
American College of Allerg Asthma Imm nolog ACAII anno nces U S alb terol inhaler shortage a message to asthma s fferers abo t a shortage of alb terol metered-dose inhalers
From Allergic Li ing ebsite Accessed Mar A ailable from https allergicli ing com acaai-anno nces- -s-alb terol-inhaler-shortage
Simonds AK Hanak A Chat in M et al E al ation of droplet dispersion d ring non-in asi e entilation o gen therap neb liser treatment and chest ph siotherap in clinical practice
implications for management of pandemic infl en a and other airborne infections Health Technol Assess - PMID DOI hta -
Neuraminidase Inhibitors (e.g., oseltamivir):

Chen N Zho M Dong X et al Epidemiological and clinical characteristics of cases of no el corona ir s pne monia in W han China a descripti e st d Lancet 2020;3 5:50 513.
PMID DOI S - -
L H Dr g treatment options for the -ne corona ir s -nCoV Biosci Trends 2020;14:6 1. PMID DOI bst
Singhal T A Re ie of Corona ir s Disease- COVID- Indian J Pediatr PMID DOI s - - -
Tan EL Ooi EE Lin CY et al Inhibition of SARS corona ir s infection in itro ith clinicall appro ed anti iral dr gs Emerg Infect Dis 2004;10:5 6. PMID DOI
eid
U S National Librar of Medicine ClinicalTrials go Accessed Mar A ailable at https clinicaltrials go
Niclosamide:
W CJ Jan JT Chen CM et al Inhibition of se ere ac te respirator s ndrome corona ir s replication b niclosamide Antimicrob Agents Chemother 4 :26 3 6. PMID DOI
acsinfectdis c
X J Shi PY Li H et al Broad Spectr m Anti iral Agent Niclosamide and Its Therape tic Potential ACS Infect Dis PMID DOI AAC -
Nitazoxanide:
Wang M Cao R Zhang L et al Remdesi ir and chloroq ine effecti el inhibit the recentl emerged no el corona ir s -nCoV in itro Cell Res 30:26 2 1. PMID DOI
s - - -
Beigel JH Nam HH Adams PL et al Ad ances in respirator ir s therape tics - A meeting report from the th isir anti iral gro p conference Anti iral Res 16 :45 6 . PMID
DOI j anti iral
X J Shi PY Li H et al Broad spectr m anti iral agent niclosamide and its therape tic potential ACS Infect Dis PMID DOI AAC -
Rossignol JF Nita o anide a ne dr g candidate for the treatment of Middle East respirator s ndrome corona ir s J Infect P blic Health Ma J n :22 30. PMID DOI
j jiph
Rossignol JF Nita o anide a first-in-class broad-spectr m anti iral agent Anti iral Res 4 103. PMID DOI j anti iral
Haffi lla J Hartman A Hoppers M et al Effect of nita o anide in ad lts and adolescents ith ac te ncomplicated infl en a a do ble-blind randomised placebo-controlled phase b
trial Lancet Infect Dis 14:60 1 . PMID DOI S - -
Gamiño-Arro o AE G errero ML McCarth S et al Efficac and safet of nita o anide in addition to standard of care for the treatment of se ere ac te respirator illness Clin Infect Dis
201 ; 6 :1 03 1 11. PMID DOI cid ci
Nitric Oxide (inhaled):

Akerstrom S Mo sa i-Ja i M Klingstom J et al Nitric o ide inhibits the replication c cle of se ere ac te respirator s ndrome corona ir s J Virol - PMID
DOI JVI -
Chen L Li P Gao H et al Inhalation of nitric o ide in the treatment of se erel ac te respirator s ndrome a resc e trial in Beijing Clin Infect Dis - PMID DOI

F ller BM Mohr NM Skr pk L et al The se of inhaled prostaglandins in patients ith ARDS a s stematic re ie and meta-anal sis Chest - PMID DOI
chest -
Griffiths MJD McA le DF Perkins GD et al G idelines on the management of ac te respirator distress s ndrome BMJ Open Resp Res e PMID DOI
bmjresp- -
Papa ian L A bron C Brochard L et al Formal g idelines management of ac te respirator distress s ndrome Ann Intensi e Care PMID PMID DOI
s - - -
Biospace Mallinckrodt E al ates the Potential Role for Inhaled Nitric O ide to Treat COVID- Associated L ng Complications Engages ith Scientific Go ernmental and Reg lator Agen
cies From the Biospace ebsite Accessed Mar https biospace com article releases mallinckrodt-e al ates-the-potential-role-for-inhaled-nitric-o ide-to-treat-co id- -
associated-l ng-complications-engages- ith-scientific-go ernmental-and-reg lator -agencies
FDA Grants Bellerophon Emergenc E panded Access for INOp lse for the Treatment of COVID- Vir s press release Warren NJ Bellerophon Therape tics Inc Mar http
in estors bellerophon com ne s-releases ne s-release-details fda-grants-bellerophon-emergenc -e panded-access-inop lser Accessed Mar
Gebistorf F Karam O Wettersle J et al Inhaled nitric o ide for ac te respirator distress s ndrome ARDS in children and ad lts Cochrane Database S st Re J n - PMID
DOI CD p b Alha ani W Moller MH Arabi YM et al S r i ing Sepsis Campaign G idelines on the Management of Criticall Ill Ad lts ith Corona
ir s Disease COVID- Crit Care Med PMID DOI CCM
Alha ani W Moller MH Arabi YM et al S r i ing Sepsis Campaign G idelines on the Management of Criticall Ill Ad lts ith Corona ir s Disease COVID- Crit Care Med
PMID DOI CCM
NSAIAs, including ibuprofen:

Fang L Karaki lakis G Roth M Are patients ith h pertension and diabetes mellit s at increased risk for COVID- infection Lancet Respir Med PMID DOI S -
-
Alha ani W Moller MH Arabi YM et al S r i ing Sepsis Campaign g idelines on the management of criticall ill ad lts ith Corona ir s Disease COVID- Intensi e Care Med
P bMed DOI s - - -
Sodhi M Etminan M Safet of Ib profen in Patients ith COVID- Ca sal or Confo nded CHEST P bMed DOI https doi org j chest
G pta R Misra Contentio s iss es and e ol ing concepts in the clinical presentation and management of patients ith COVID- infection ith reference to se of therape tic and other
dr gs sed in co-morbid diseases h pertension diabetes etc Diabetes Metab S ndr - P bMed DOI j ds
Amici C Di Caro A Ci cci A et al Indomethacin has a potent anti iral acti it against SARS corona ir s Anti ir Ther - PMID
Remdesi ir
Wang M Cao R Zhang L et al Remdesi ir and chloroq ine effecti el inhibit the recentl emerged no el corona ir s -nCoV in itro Cell Res - P bMed
DOI s - - -
Agostini ML Andres EL Sims AC et al Corona ir s S sceptibilit to the Anti iral Remdesi ir GS- Is Mediated b the Viral Pol merase and the Proofreading E oribon clease mBio
P bMed DOI mBio -
Bro n AJ Won JJ Graham RL et al Broad spectr m anti iral remdesi ir inhibits h man endemic and oonotic deltacorona ir ses ith a highl di ergent RNA dependent RNA pol merase
Anti iral Res P bMed DOI j anti iral
Sheahan TP Sims AC Graham RL et al Broad-spectr m anti iral GS- inhibits both epidemic and oonotic corona ir ses Sci Transl Med P bMed DOI
scitranslmed aal
de Wit E Feldmann F Cronin J et al Proph lactic and therape tic remdesi ir GS- treatment in the rhes s macaq e model of MERS-CoV infection Proc Natl Acad Sci U S A
P bMed DOI pnas
Gordon CJ Tchesnoko EP Feng JY et al The anti iral compo nd remdesi ir potentl inhibits RNA-dependent RNA pol merase from Middle East respirator s ndrome corona ir s J Biol
Chem P bMed DOI jbc AC
Sheahan TP Sims AC Leist SR et al Comparati e therape tic efficac of remdesi ir and combination lopina ir ritona ir and interferon beta against MERS-CoV Nat Comm n
P bMed DOI s - - -
Ko WC Rolain JM Lee NY et al Arg ments in fa or of remdesi ir for treating SARS-CoV- infections Int J Antimicrob Agents Editorial P bMed DOI
j ijantimicag
Martine MA Compo nds ith therape tic potential against no el respirator corona ir s Antimicrob Agents Chemother P bMed DOI AAC -
St d to e al ate the safet and anti iral acti it of remdesi ir GS- in participants ith se ere corona ir s disease COVID- NCT https clinicaltrials go ct
sho NCT
St d to e al ate the safet and anti iral acti it of remdesi ir GS- in participants ith moderate corona ir s disease COVID- compared to standard of care treatment
NCT https clinicaltrials go ct sho NCT
E panded access remdesi ir RDV GS- https clinicaltrials go ct sho NCT
Adapti e COVID- treatment trial ACTT NCT https clinicaltrials go ct sho NCT
Lai CC Li YH Wang CY et al As mptomatic carrier state ac te respirator disease and pne monia d e to se ere ac te respirator s ndrome corona ir s SARS-CoV- Facts and m ths J
Microbiol Imm nol Infect P bMed DOI j jmii
Gilead Sciences Compan statement on access to remdesi ir o tside of clinical trials Accessed Mar https gilead com ne s-and-press compan -statements gilead-sciences-
statement-on-access-to-remdesi ir-o tside-of-clinical-trials
Grein J Ohmagari N Shin D et al Compassionate se of remdesi ir for patients ith se ere Co id- N Engl J Med Ep b DOI NEJMoa
E panded access treatment protocol remdesi ir RDV GS- for the treatment of SARS-CoV CoV infection COVID- NCT https clinicaltrials go ct sho
NCT cond NCT
Cho KT Wong AYL Kae preedee P et al Remdesi ir lopina ir emetine and homoharringtonine inhibit SARS-CoV- replication in itro Anti ir Res Apr Ep b ahead of print
https doi org j anti iral PMID DOI j anti iral
Williamson BN Feldmann F Sch ar B et al Clinical benefit of remdesi ir in rhes s macaq es infected ith SARS-CoV- Preprint not peer re ie ed https
doi org
Wang Y Zhang D D G et al Remdesi ir in ad lts ith se ere COVID- a randomi ed do ble-blind placebo-controlled m lticentre trial Lancet Apr Ep b DOI S -
- https doi org S - -
National Instit tes of Health NIH clinical trial sho s remdesi ir accelerates reco er from ad anced COVID- Press release Apr A ailable at https nih go ne s-e ents
ne s-releases nih-clinical-trial-sho s-remdesi ir-accelerates-reco er -ad anced-co id-
Gilead Sciences Gilead anno nces res lts from phase trial of in estigational anti iral remdesi ir in patients ith se ere COVID- Press release Apr A ailable at https
gilead com ne s-and-press press-room press-releases gilead-anno nces-res lts-from-phase- -trial-of-in estigational-anti iral-remdesi ir-in-patients- ith-se ere-co id-
Gordon CJ Tshesnoko EP Woolner E et al Remdesi ir is a direct-acting anti iral that inhibits RNA-dependent RNA pol merase from se ere ac te respirator s ndrome corona ir s ith
high potenc J Biol Chem Apr Ep b ahead of print PMID DOI jbc RA
US Food and Dr g Administration Letter of a thori ation Emergenc se a thori ation for se of remdesi ir for the treatment of hospitali ed corona ir s disease COVID- patients
Ma From FDA ebsite https fda go media do nload
US Food and Dr g Administration Fact sheet for health care pro iders Emergenc se a thori ation EUA of remdesi ir GS- From FDA ebsite https fda go media
do nload
US Food and Dr g Administration Fact sheet for patients and parent caregi ers Emergenc se a thori ation EUA of remdesi ir for corona ir s disease COVID- From FDA eb
site https fda go media do nload
Ruxolitinib
Inc te anno nces plans to initiate a phase clinical trial of r olitinib Jakafi as a treatment for patients ith COVID- associated c tokine storm Press release Inc te Apr
https in estor inc te com ne s-releases ne s-release-details inc te-anno nces-plans-initiate-phase- -clinical-trial
U S National Librar of Medicine ClinicalTrials go Accessed Ma A ailable from https clinicaltrials go ct sho NCT
U S National Librar of Medicine ClinicalTrials go Accessed Ma A ailable from https clinicaltrials go ct res lts cond COVID term r olitinib cntr state cit dist
Mehta P McA le DF Bro n M et al COVID- consider c tokine storm s ndromes and imm nos ppression Lancet Mar pii S - - Ep b ahead of print PMID
DOI S - -
Zhang W Zhao Y Zhang F et al The se of anti-inflammator dr gs in the treatment of people ith se ere corona ir s disease COVID- the perspecti es of clinical imm nologists
from China Clin Imm nol PMID DOI j clim
Chinese Clinical Trial Registr Accessed Apr A ailable at http chictr org cn eninde asp
Elli EM Barate C Mendicino F et al Mechanisms nderl ing the anti-inflammator and Imm nos ppressi e acti it of r olitinib Front Oncol PMID DOI
fonc
Sarilumab:
Genentech Inc So th San Francisco CA Actemra se in Corona ir s Disease COVID- standard repl letter Mar
National Health Commission and State Administration of Traditional Chinese Medicine Diagnosis and Treatment Protocol for No el Corona ir s Pne monia Trial Version Mandarin
English translation Mar
Sanofi and Regeneron begin global Ke ara saril mab clinical trial program in patients ith se ere COVID- press release Cambridge Mass and Tarr to n NY Sanofi March
http ne s sanofi s - - -Sanofi-and-Regeneron-begin-global-Ke ara-R-saril mab-clinical-trial-program-in-patients- ith-se ere-COVID- Accessed Mar
Sanofi and Regeneron Pharmace ticals Inc Cambridge MA and Tarr to n NY Saril mab and COVID- standard repl letter Mar
Sanofi Gen me Cambridge MA Personal comm nication
Sirolimus:
Stohr S Costa R Sandmann L et al Host cell mTORC is req ired for HCV RNA replication G t - PMID DOI g tjnl- -
Kindrach k J Ork B Hart BJ et al Anti iral potential of ERK MAPK and PI K AKT mTOR signaling mod lation for middle east respirator s ndrome corona ir s infection as identified b tem
poral kinome anal sis Antimicrob Agents Chemother - PMID DOI AAC -
Wang CH Ch ng FT Lin SM et al Adj ant treatment ith a mammalian target of rapam cin inhibitor sirolim s and steroids impro es o tcomes in patients ith se ere H N pne monia
and ac te respirator fail re Crit Care Med - PMID DOI CCM b e a d
Zho Y Ho Y Shen J et al Net ork-based dr g rep rposing for no el corona ir s -nCoV SARS-CoV- Cell Disco er -
Arabi YM Fo ler R and Ha den FG Critical care management of ad lts ith comm nit -acq ired se ere respirator iral infection Intensi e Care Med - PMID
DOI s - - -
Tissue Plasminogen Activator (t-PA; alteplase):

Moore HB Barrett CD Moore EE et al Is there a role for tiss e plasminogen acti ator tPA as a no el treatment for refractor COVID- associated ac te respirator distress s ndrome
ARDS J Tra ma Ac te Care S rg DOI TA
Massach setts Instit te of Technolog MIT ne s a stopgap meas re to treat respirator distress From the MIT ebsite Accessed Apr A ailable from http ne s mit ed
co id- -treat-respirator -patients-plasminogen-
Harda a RM Harke H T roch AH et al Treatment of se ere ac te respirator distress s ndrome a final report on a phase I st d Am S rg - PMID
Beth Israel Deaconess Medical Center BIDMC la nches clinical trial to assess common anti-clotting medication for treatment of COVID- -related respirator fail re From the BIDMC eb
site Accessed Apr A ailable from https bidmc org abo t-bidmc ne s co id- -anti-clotting-medication
Deng Y Li W Li K et al Clinical characteristics of fatal and reco ered cases of corona ir s disease COVID- in W han China a retrospecti e st d Chin Med J Engl PMID
DOI CM
Li T L H Zhang W Clinical obser ation and management of COVID- patients Emerg Microbes Infect - PMID DOI
W C Chen X Cai Y et al Risk factors associated ith ac te respirator distress s ndrome and death in patients ith corona ir s disease pne monia in W han China JAMA Intern
Med PMID DOI jamainternmed
American Societ of Hematolog COVID- and coag lopath freq entl asked q estions From the ASH ebsite Accessed Apr A ailable from https hematolog org co id-
co id- -and-coag lopath
Wang J Haji adeh N Moore EE et al Tiss e plasminogen acti ator tPA treatment for COVID- associated ac te respirator distress s ndrome ARDS a case series J Thromb Haemost
PMID DOI jth
Tang N Li D Wang X et al Abnormal coag lation parameters are associated ith poor prognosis in patients ith no el corona ir s pne monia J Thromb Haemost - PMID
DOI jth
MacLaren R Stringer KA Emerging role of anticoag lants and fibrinol tics in the treatment of ac te respirator distress s ndrome Pharmacotherap - PMID DOI
phco
Cho dh r R Barrett CD Moore HB et al Sal age se of tiss e plasminogen acti ator tPA in the setting of ac te respirator distress s ndrome ARDS d e to COVID- in the USA a Marko
decision anal sis World J Emerg S rg PMID DOI s - - -
Barrett CD Moore HB Yaffe MB et al ISTH interim g idance on recognition and management of coag lopath in COVID- a comment J Thromb Haemost PMID DOI
jth
D nn JS Na ar R Campos J et al Feasibilit of tiss e plasminogen acti ator form lated for p lmonar deli er Pharm Res - PMID DOI s - -
-
Ran cci M Ballotta A Di Dedda U et al The procoag lant pattern of patients ith COVID- ac te respirator distress s ndrome J Thromb Haemost PMID DOI
jth
Tocilizumab:
Genentech Inc So th San Francisco CA Actemra se in Corona ir s Disease COVID- standard repl letter Apr
National Health Commission and State Administration of Traditional Chinese Medicine Diagnosis and Treatment Protocol for No el Corona ir s Pne monia Trial Version Mandarin
English translation Mar
U S National Librar of Medicine ClinicalTrials go Accessed Apr A ailable from https clinicaltrials go ct sho st d NCT NLM identifier NCT
Mehta P McA le DF Bro n M et al COVID- consider c tokine storm s ndromes and imm nos ppression Lancet Mar pii S - - Ep b ahead of print
PMID DOI S - -
F Hoffmann-La Roche Ltd Roche initiates Phase III clinical trial of Actemra RoActemra in hospitali ed patients ith se ere COVID- pne monia press release Basel S it erland Roche
March https roche com dam jcr f cbbb - d- d -bbea- f cf f b en -mr-actemra-co id- -trial-en pdf Accessed Apr
L o P Li Y Qi L et al Tocili mab treatment in COVID- a single center e perience J Med Virol Apr Ep b ahead of print
P bMed DOI jm A ailable from https onlinelibrar ile com doi epdf jm
World Health Organi ation WHO R D Bl eprint COVID- Informal cons ltation on the potential role of IL- IL- antagonists in the clinical management of COVID infection Mar
A ailable at https ho int bl eprint priorit -diseases ke -action E pert gro p IL IL call mar pdf Accessed Apr
Alberici F Delbarba E Manenti C et al A single center obser ational st d of the clinical characteristics and short-term o tcome of kidne transplant patients admitted for SARS-CoV
pne monia Kidne Int Apr Ep b ahead of print A ailable at https doi org j kint
Zhang X Song K Tong F et al First case of COVID- in a patient ith m ltiple m eloma s ccessf ll treated ith tocili mab Blood Ad - P bMed DOI
bloodad ances
Li B Li M Zho et al Can e se interle kin- IL- blockade for corona ir s disease COVID- -ind ced c tokine release s ndrome CRS J A toimm n Ep b ahead
of print DOI j ja t A ailable at https doi org j kint
Umifenovir:
Deng L Li C Zeng Q et al Arbidol combined ith LPV r ers s LPV r alone against Corona Vir s Disease A retrospecti e cohort st d J Infect P bMed DOI
j jinf
U S National Librar of Medicine ClinicalTrials go Accessed Mar A ailable from https clinicaltrials go ct sho st d NCT NLM identifier NCT
Blaising J Pol ak SJ Peche r EI Arbidol as a broad-spectr m anti iral an pdate Anti iral Res - P bMed DOI j anti iral
Dong L H S Gao J Disco ering dr gs to treat corona ir s disease COVID- Dr g Disco Ther - P bMed DOI ddt
Chen C H ang J Cheng Z et al Fa ipira ir ers s arbidol for COVID- A randomi ed clinical trial MedR i Posted March DOI https doi org
National Health Commission NHC State Administration of Traditional Chinese Medicine Trial Version Diagnosis and treatment protocol for no el corona ir s pne monia http b san
china-cons late org chn t P pdf
Zh Z L Z X T et al Arbidol monotherap is s perior to lopina ir ritona ir in treating COVID- J Infect Ep b ahead of print P bMed DOI j jinf
The information contained in this evidence table is emerging and rapidly evolving because of ongoing research and is subject to the professional judgment and interpretation of the practi-
i e d e he i e e f each edical facili a ach he ca e f a ie i h COVID-19 and the needs of individual patients. ASHP provides this evidence table to help practi-
tioners better understand current approaches related to treatment and care. ASHP has made reasonable efforts to ensure the accuracy and appropriateness of the information presented.
However, any reader of this information is advised ASHP is not responsible for the continued currency of the information, for any errors or omissions, and/or for any consequences arising
from the use of the information in the evidence table in any and all practice settings. Any reader of this document is cautioned that ASHP makes no representation, guarantee, or warranty,
express or implied, as to the accuracy and appropriateness of the information contained in this evidence table and will bear no responsibility or liability for the results or consequences of
its use.

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Assessment of Evidence for COVID-19-Related Treatments: Updated 5/6/2020

ANTIVIRAL AGENTS SUPPORTING AGENTS OTHER

Emergency use authorization (EUA) for

Italy: Randomi ed placebo-controlled Beca se high fa ipira ir concentra

Multiple clinical trials initiated in pts ith

LPV/RTV Clinical Experience (COVID- ):

LPV/RTV Clinical Experience (SARS and

LPV/RTV COVID- Clinical Trials at clini-

Darunavir COVID- Clinical Trials:

Hydroxychloroquine with azithromycin

Hydroxychloroquine (with or without

Efficacy measures: Initial st dies e al

M ltiple clinical trials to e al ate h

M ltiple clinical trials to e al ate h

COVID- cases in hospitals in China there

Neither oseltami ir nor anami ir has

Clinicaltrials go trials for COVID- that

Phase randomized, open-label trial in pts

Phase adaptive, randomized, placebo-

Expanded access IND protocol

Compassionate use access: The man fac

Compassionate use access (NCT ):

Data from the manufacturer’s compas-

Open-label, prospective, randomized,

Clinical trials initiated in China:

NCT Randomi ed open-label

Oral ascorbic acid: Note Ma interfere ith laborator

Incl ded as a component of some h

Pne monia Limited st d data a ailable

Common cold Effect of oral s pplementa

release s ndrome CRS in Other planned clinical trials ill e al ate

Potential to limit COVID- -

e perts s ggest higher dosages of corti

Septic shock: The effect of corticoster

Patients receiving corticosteroid thera-

Endocrinolog e perts state that pa

Pregnancy considerations: For pregnant

s stemic corticosteroids do not cross

place is a ailable at https

FDA g idance s ggests that collection of

FDA g idance s ggests that a minim m

FDA g idance s ggests that the follo

Open-label, multicenter, randomized con-

M ltiple clinical trials ha e been initiated in

A non-randomi ed pilot st d registered at

Clinical trials e al ating inhaled nitric

On March th Bellerophon Ther

Expanded-access program NCT

Other earlier-phase smaller and or open-

Clinicaltrials go link https

Zhang et al from China reported on a pa

C rrentl there are no ell-controlled

China Randomi ed m lticenter con

US/Global randomized, placebo-

Abr pt ithdra al of RAAS inhibitors in

The American Societ of Hematolog

The risk of eno s thromboembolism

Bleeding appears to be infreq ent in

Most statins are s bstrates for the

In hospitals clinicians t picall se neb