Treatment

Antiviral medications are under investigation for COVID-19, though none have yet been shown to be clearly effective on mortality in published randomised controlled trials. Emergency use authorisation for remdesivir was granted in the U.S. on 1 May 2020, for people hospitalised with severe COVID-19. In September 2020, following a review of later research, the WHO recommended that remdesivir not be used for any cases of COVID-19, as there was no good evidence of benefit. In severe cases, the use of corticosteroids can reduce the risk of death.

Taking over-the-counter cold medications, drinking fluids, and resting may help alleviate symptoms. Depending on the severity, oxygen therapy, intravenous fluids, and breathing support may be required. The safety and effectiveness of convalescent plasma as a treatment option requires further research.

Other trials are investigating whether existing medications can be used effectively against COVID-19 or the immune reaction to it. On 16 June 2020, the RECOVERY Trial group released a statement that their preliminary results show low dose dexamethasone reduces mortality in patients receiving respiratory support, though previous reviews had suggested the use of steroids may worsen outcomes. Demand for dexamethasone surged after publication of the preprint. On 2 September 2020, the WHO recommended treatment with systemic steroids for patients with severe and critical symptoms, but continued to advise against their use for other patients.

A study of major hospitals in the U.S. found that abnormal liver tests occurred in most hospitalized patients with COVID-19 and may be associated with poorer clinical outcomes. Tocilizumab was significantly associated in the relationship between the drugs used to treat the disease and abnormal liver tests, which prompted studies to determine whether abnormal results were due to coronavirus or drug-induced liver injury, according to Michael Nathanson, director of the Yale Liver Center and co-author of the study.

On 9 November 2020, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the investigational monoclonal antibody therapy bamlanivimab for the treatment of mild-to-moderate COVID-19 in adult and pediatric patients.Monoclonal antibodies are laboratory-made proteins that mimic the immune system's ability to fight off harmful antigens such as viruses. Bamlanivimab is a monoclonal antibody that is specifically directed against the spike protein of SARS-CoV-2, designed to block the virus' attachment and entry into human cells.

On 19 November 2020, the FDA issued an EUA for the combination of baricitinib with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized people two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). The data supporting the EUA for baricitinib combined with remdesivir are based on a randomized, double-blind, placebo-controlled clinical trial (ACTT-2), which was conducted by the National Institute of Allergy and Infectious Diseases (NIAID). The EUA was issued to Eli Lilly and Company.

During pregnancy

To date, most SARS-CoV-2-related clinical trials have excluded, or included only a few, pregnant or lactating women. This limitation makes it difficult to make evidence-based therapy recommendations in these patients and potentially limits their COVID-19 treatment options. The US CDC recommends shared decision-making between the patient and the clinical team when treating pregnant women with investigational medication.