From:  Prophylactic and therapeutic potential of vitamin D in asthma during the COVID-19 pandemic: the new hope?
 

Therapeutic management of COVID-19

Hospital statusTreatment
Outpatients
Mild-moderate symptoms (no supplemental oxygen requirements)

  • Symptom management

  • The use of dexamethasone is contradicted

Patients at high risk of severe COVID-19 (e.g., elderly, immunocompromised, > 6 months since vaccinated)

  • Ritonavir-boosted nirmatrelvira,b

  • Remdesivirb

Inpatients
No supplemental oxygen

  • Dexamethasone not indicated

  • Prophylactic dose of heparin (anticoagulant)

High risk of severe COVID-19

  • Remdesivirc

Immunocompromised undergoing

  • Remdesivirc

    a) Conventional oxygen supplementation
        Require minimal conventional oxygen

  • Remdesivir

  • Prophylactic dose of heparin

        Most patients (combined therapy)

  • Remdesivir + dexamethasone

  • Heparin

        Patients receiving dexamethasone with respiratory distress and systemic inflammation

  • + Immunomodulator (e.g., baricitinib)

    b) HFNC oxygen, NIV, MV, or ECMO
        All patientsd

  • Dexamethasone

  • Immunomodulator (e.g., baricitinib)

  • Heparin

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COVID-19: coronavirus disease 2019; HFNC: high-flow nasal cannula; NIV: noninvasive ventilation; MV: mechanical ventilation; ECMO: extracorporeal membrane oxygenation. a Recommended 5-day treatment; b treatment therapy to be initiated immediately within 5–7 days of COVID-19 symptomology; c to be administered within 10 days of symptom onset; d add on remdesivir in the immunosuppressed or evidence of ongoing viral replication. +: add on medication