Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the COVID-19 pandemic. The virus is spread primarily through transmission of respiratory droplets during face-to-face contact. Infection with SARS-CoV-2 may or may not cause symptoms, and when symptoms are present, they can be mild, moderate, or severe. 1
Symptoms appear 2 to 14 days after being exposed to COVID-19. The most common symptoms of COVID-19 at presentation: 2
Loss of smell
Weakness and lack of energy
Muscle aches and pain
Loss of taste
Clinical manifestations: 3
Asymptomatic or presymptomatic
Asymptomatic or Presymptomatic
Individuals who test positive using a virologic test but who have no symptoms that are consistent with COVID-19
Various symptoms (eg, fever, cough, sore throat, headache, malaise, muscle pain, etc.) without shortness of breath, dyspnea, or abnormal chest imaging
SpO2 ≥94% on room air and lower respiratory disease evidenced by clinical assessment or imaging
SpO2 <94% on room air, PaO2/FiO2 <300, respiratory rate>30 breaths/min, or lung infiltrates >50%
Respiratory failure, septic shock, and/or multiorgan dysfunction
If you have symptoms of COVID-19
If you have been within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period with someone who has tested positive for COVID-19
If you have traveled, attended large social gatherings, or have been in a crowded indoor setting
If you have been asked to get tested by a healthcare provider, state, tribal, local, or territorial health department
Following an exposure to someone with COVID-19, you do not have to get tested for SARS-CoV-2 infection: 4
If you have been fully vaccinated
If you have recovered from COVID-19 within the past 3 months as long as you don’t develop new symptoms
If you have mild symptoms of COVID-19, you can recover at home without medical care. If your symptoms get worse, contact your healthcare provider. If you or someone else is showing signs of severe COVID-19, seek emergency medical care immediately. The emergency signs include: 5
Persistent pain or pressure in the chest
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
Know your risk factors for severe COVID-19 6
Chronic kidney disease
Chronic lung diseases (eg: COPD, asthma, interstitial lung disease, cystic fibrosis, pulmonary hypertension)
Dementia or other neurological conditions
Heart conditions (eg: heart failure, coronary artery disease, or cardiomyopathies)
Immunocompromised state (weakened immune system) from solid-organ transplantation
Overweight (BMI >25 kg/m2 but <30 kg/m2), obesity (body-mass index>30 kg/m2 but <40 kg/m2), or severe obesity (BMI ≥40 kg/m2)
People from racial and ethnic minority groups
People with disabilities
Sickle cell disease or thalassemia
Smoking, current or former
Solid organ or blood stem cell transplant
Stroke or cerebrovascular disease
Substance use disorders
Type 1 or 2 diabetes mellitus
Dual monoclonal antibody cocktails with emergency use authorization (EUA) contain two potent antibodies that bind to different receptors of the SARS-CoV-2 spike protein and prevent them from entering host cells. Two monoclonal antibody cocktails can be used in nonhospitalized patients with mild to moderate symptoms of COVID-19:
Bamlanivimab and etesevimab 7
Casirivimab and imdevimab 8
These therapies must be given as soon as possible and within 10 days of symptoms for the treatment of mild-to-moderate COVID-19 in patients: 7, 8
Who are at least 12 years of age and weigh at least 40 kg
Have positive results of direct SARS-CoV-2 viral testing
Who are at high-risk of progressing to severe COVID-19 or hospitalization
Click on the link to the monoclonal antibody eligibility tool for patients which will guide you through a series of questions to determine if you are eligible for these infusion therapies. You may also download and print a copy of the decision tree to share with your healthcare provider.
Watch this video to hear people share their experience with these infusion therapies for COVID-19.
Recommended for hospitalized patients with severe COVID-19
Most benefit seen in those with severe COVID-19 on supplemental oxygen rather than patients on mechanical ventilation or ECMO
Recommended for hospitalized patients with severe COVID-19
Not recommended for hospitalized patients without hypoxemia requiring supplemental oxygen
|Baricitinib + Remdesivir||
Combination recommended over remdesivir alone in those who cannot receive corticosteroids because of a contraindication
Recommended in addition to standard of care in hospitalized patients with progressive severe or critical COVID-19 who have elevated markers of systemic inflammation
COVID-19 vaccines help to develop immunity without having to get the illness. COVID-19 vaccines with EUA:
Pfizer-BioNTech COVID-19 vaccine 9
Moderna COVID-19 vaccine 10
Janssen COVID-19 vaccine 11
Viruses are constantly changing, and new variants emerge over time. Sometimes they emerge and then disappear, sometimes they emerge and persist. Variants of concern are those that may be more easily spread, cause more severe disease, reduce efficacy of vaccines and treatments, and create diagnostic challenges compared with strains that were previously circulating. 12
Variants of concern of the COVID-19 virus that were first identified abroad are now circulating in the United States, in addition to two variants first identified in California: 11
B.1.1.7 (United Kingdom)
B.1.351 (South Africa)
1 Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324(8):782-793.
2 Lechien JR, Chiesa-Estomba CM, Place S et al. Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020;288(3):335-344.
3 NIH. Clinical spectrum of SARS-CoV-2 infection.
https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/. URL accessed April 2, 2021.
4 CDC. Test for Current Infection.
https://www.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html. URL accessed April 2, 2021.
5 CDC. What to Do If You Are Sick.
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html. URL accessed April 2, 2021.
6 CDC. People with Certain Medical Conditions.
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. URL accessed April 2, 2021.
7 Bhimraj A, Morgan RL, Shumaker AH, et al. IDSA Guidelines on the treatment
and management of patients with COVID-19. Infectious Diseases Society of America 2021; Version 4.1.1.
www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/. Accessed April 2, 2021.
8 FDA. Fact Sheet for Health Care Providers Emergency Use Authorization
(EUA) of Casirivimab and Imdevimab. Available at
https://www.fda.gov/media/143892/download. Accessed April 2, 2021.
9 FDA. Fact Sheet for Health Care Providers Emergency Use Authorization
(EUA) of Bamlanivimab and Etesevimab. Available at
https://www.fda.gov/media/145802/download. Accessed April 2, 2021..
10 FDA. Pfizer-BioNTech COVID-19 Vaccine. Available at
https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine/. Accessed April 2, 2021.
11 FDA. Moderna COVID-19 Vaccine. Available at
https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccine/. Accessed April 2, 2021.
12 FDA. Janssen COVID-19 Vaccine. Available at
https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/janssen-covid-19-vaccine/. Accessed April 2, 2021.
13 CDC. SARS-CoV-2 Variant Classification and Definitions. Available at https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/variant-surveillance/variant-info.html#Concern. Accessed April 2, 2021.