COVID-19 Treatment Guidelines

Disease Classification and Initial Assessment

COVID-19 severity is classified as mild, moderate, severe, or critical based on clinical presentation and oxygen requirements, with mild illness characterized by symptoms without respiratory distress or abnormal imaging, moderate illness by lower respiratory disease with SpO2 ≥94% on room air, severe illness by SpO2 <94% on room air, and critical illness by requiring ICU admission or mechanical ventilation 3
The European Respiratory Society recommends classifying COVID-19 severity based on clinical presentation and oxygen requirements 3

The European Respiratory Society strongly recommends corticosteroids for patients requiring oxygen or ventilatory support, with a mortality benefit in patients requiring oxygen and mechanical ventilation 1, 2
For high-risk patients with mild disease, the European Society for Medical Oncology recommends considering anti-SARS-CoV-2 monoclonal antibodies if available 4
The European Respiratory Society recommends against routine antibiotics unless there is clinical suspicion of bacterial infection 3
The American Thoracic Society recommends prophylactic-dose anticoagulation for hospitalized patients requiring oxygen 5, 1

The European Respiratory Society recommends dexamethasone 6 mg daily for up to 10 days for patients requiring oxygen or ventilatory support, with a strong recommendation against its use in patients not requiring oxygen 1, 2
The European Respiratory Society recommends against the use of hydroxychloroquine, lopinavir-ritonavir, azithromycin, colchicine, and interferon-β 1

The European Respiratory Society recommends routine antibiotics only when there is clinical evidence of bacterial infection 3
The European Respiratory Society recommends considering high-flow nasal cannula or CPAP for hypoxemic respiratory failure without immediate indication for intubation 1
The European Respiratory Society recommends early rehabilitation care when patients are stable 7, 8
The European Respiratory Society recommends psychological support and mental health interventions for anxiety, fear, and depression 7, 8

The European Society for Medical Oncology recommends considering monoclonal antibodies, convalescent plasma, or other specific therapies for patients with hematological malignancies or immunocompromised status 4
The Infectious Diseases Society of America recommends liposomal amphotericin B as the primary therapy of choice for patients with COVID-19 associated mucormycosis 9, 10

The European Respiratory Society recommends avoiding delaying corticosteroid therapy in patients requiring oxygen 1, 2
The European Respiratory Society recommends avoiding the use of corticosteroids in patients not requiring oxygen 1, 2
The European Respiratory Society recommends avoiding routine use of antibiotics without evidence of bacterial infection 3
The European Respiratory Society recommends avoiding delaying intubation when non-invasive respiratory support fails 6
The American College of Chest Physicians recommends avoiding overlooking the need for anticoagulation in hospitalized patients 5, 1