Hospitalized Patients

The medications that have been reviewed, but due to lack of evidence, these medications are not currently recommended for the treatment of COVID-19

Revision History

  • 03/15/2020
    • General treatment options, dosing, and monitoring
  • 03/19/2020
    • Testing guidance for asymptomatic and symptomatic patients
    • Added therapeutic options based on severity using scale and laboratory monitoring for patients with COVID-19
    • Updated dosing for hydroxychloroquine
    • Corticosteroids: use of steroids in patients with severe disease could be considered as part of the supportive care regimen for patients with ARDS on a case-by-case basis
    • ACEi/ARB: advised against adding/removing beyond in standard practice
    • NSAIDs: no evidence for against the management of fever with NSAIDs
    • Guidance for use of nebulized respiratory medications
    • Removed chloroquine, ribavirin, atazanavir/ritonavir, atazanavir/cobicistat, darunavir/cobicistat
    • Added Tocilizumab
    • Post-exposure prophylaxis for patients and health care workers
  • 03/21/2020
    • Added: Discharge patients should be offered supportive care (anti-pyretics, MDI, etc.)
  • 03/25/2020
    • Updated treatment options based on severity score:
      • Severity score 1: removed hydroxychloroquine, lopinavir/ritonavir, darunavir/ritonavir
      • Severity score 2-3: no change
      • Severity score ≥ 4: Remdesivir for eligible patients first, if not: hydroxychloroquine. Removed combination of hydroxychloroquine plus lopinavir/ritonavir or darunavir/ritonavir
    • Lower dose glucocorticoids (equivalent to methylprednisolone 1-2 mg/kg/day for 3-5 days or ≤0.5-1 mg/kg/day methylprednisolone for ≤ 7 days) have been recommended after careful consideration of risks and benefits.
    • Azithromycin: insufficient evidence to recommend the use of azithromycin in addition to hydroxychloroquine
    • ECG monitoring at baseline for all hospitalized patients
  • 03/31/2020
    • Revised the duration of treatment
      • Severity score: 2-3: changed from 10 days to 5-7 days
      • Severity score ≥ 4: changed from 10-14 days to 7-10 days
    • Corticosteroids: early initiation of lower dose glucocorticoids (equivalent to methylprednisolone 1-2 mg/kg/day for 3-5 days or ≤0.5-1 mg/kg/day methylprednisolone for ≤ 7 days) have been recommended for patients with refractory shock and/or ARDS
    • Removed darunavir/ritonavir
    • Added Sarilumab with criteria for use
  • 4/15/2020
    • Added: statement regarding use of off-label experimental therapies with only in vitro data
    • Added recommendation against use of ivermectin
    • Added anticoagulation pathway
    • Added guidance on cardiac monitoring
    • Added additional steroid guidance and chart with risk factors for CRS
    • Added restriction to ID for lopinavir/ritonavir
    • Revised daily monitoring parameters
  • 4/20/2020
    • Added statement regarding use of micronutrients, Zinc and Vitamin C
  • 4/27/2020
    • Removed lopinavir/ritonavir from algorithm
    • Added comment regarding use of hydroxychloroquine
    • Updated remdesivir information for compassionate use
  • 4/29/2020
    • Updated anticoagulation algorithm, removal of ROTEM
    • Added statement regarding use of tPA
  • 5/12/2020
    • Removed hydroxychloroquine from algorithm
  • 5/18/2020
    • Added guidance for outpatient anticoagulation
    • Removed cardiac monitoring for patients receiving hydroxychloroquine
    • Removed statement regarding empiric initiation of experimental/investigational therapies for severity score ≥ 4
    • Included information on remdesivir emergency use authorization
    • Included information on convalescent plasma
  • 5/26/2020
    • Clarification of outpatient anticoagulation recommendations
  • 6/4/2020
    • Updated allocation information on remdesivir
  • 6/9/2020
    • Updated DOH link to request remdesivir for State of Florida (outside of CFDS)
  • 6/18/2020
    • Addition of low-dose dexamethasone recommendation
    • Removal of remdesivir compassionate use information
    • Edited remdesivir allocation information
  • 6/30/2020
    • Added warning against use of hydroxychloroquine
    • Modified IL6 antagonist recommendation to include use for severity score ≥ 2
    • Updated remdesivir access process
  • 7/3/2020
    • Removal of sarilumab from algorithm
    • Updated tocilizumab recommendation to include use for severity score ≥ 3
  • 7/14/2020
    • Modified remdesivir criteria for use
  • 8/5/2020
    • Revised remdesivir criteria for use
    • Updated multi-state convalescent plasma inclusion criteria
    • Removal of HERO study details as trial has stopped enrollment
    • Addition of statement regarding insufficient data on use of tocilizumab
  • 8/25/2020
    • Updated convalescent plasma criteria based on FDA’s EUA announcement
  • 9/3/2020
    • Updated verbiage regarding remdesivir criteria for use
  • 10/27/2020
    • Updated remdesivir information to reflect changes in regulatory requirements based on FDA approval of remdesivir on 10/22/20
    • Removed tocilizumab and recommended against routine use
  • 11/12/2020
    • Added bamlanivimab
  • 11/19/2020
    • Added NIH and IDSA recommendations and references for use of bamlanivimab in outpatients
  • 11/24/2020
    • Reviewed available data and EUA information on baricitinib
  • 12/3/2020
    • Added casirivimab/imdevimab
  • 12/22/2020
    • Revised language regarding baricitinib
  • 1/7/2021
    • Updated verbiage regarding use of ivermectin
  • 1/12/2021
    • Added tocilizumab back into treatment algorithm
  • 2/4/2021
    • Included information on colchicine for non-hospitalized patients
  • 2/9/2021
    • Modified tocilizumab recommendation to include only patients with severity score ≥3
    • Updated convalescent plasma EUA criteria
  • 2/11/2021
    • Updated EUA information on convalescent plasma
    • Added EUA information for bamlanivimab/etesevimab combination
    • Added additional links to ivermectin
  • 2/18/2021
    • Updated information on convalescent plasma severity score recommendations based on EUA
  • 3/02/2021
    • Updated inpatient and outpatient anticoagulation algorithm
  • 3/10/2021
    • Added additional study evaluating ivermectin
    • Updated information and recommendations on MABs
  • 3/25/2021
    • Updated criteria for use for remdesivir to include option to use in patients on high flow oxygen
    • Updated information and recommendations on MABs
  • 4/20/2021
    • Updated guideline recommendations on MABs
    • Included FDA EUA updates and information on the revoked EUA for bamlanivimab monotherapy
  • 5/3/2021
    • Updated tocilizumab criteria to reflect provider restrictions
  • 5/25/2021
    • Updated EUA requirements for MABs
  • 5/27/2021
    • Updated bamlanivimab-etesevimab information on distribution to the state of Florida
  • 6/3/2021
    • Modified recommendation for use of COVID-19 convalescent plasma
  • 6/7/2021
    • Updated FDA EUA information for casirivimab/imdevimab: new dosing and route of administration
  • 6/15/2021
    • Clarified language regarding scientific basis for avoiding routine use of remdesivir in patients on room air or mechanical ventilation
    • Removed statement about insufficient data for baricitinib and the warning against use of baricitinib with corticosteroids
    • Updated FDA EUA information for new MAB, Sotrovimab
  • 6/25/2021
    • Updated information regarding distribution of bamlanivimab-etesevimab in the U.S.
  • 07/13/2021
    • Updated tocilizumab to reflect EUA and results of the RECOVERY trial
  • 07/29/2021
    • Added bradycardia and hypotension to Adverse Effects for remdesivir
    • Updated baricitinib information to reflect update to EUA
  • 8/5/2021
    • Updated EUA criteria for casirivimab-imdevimab for use in post-exposure prophylaxis
    • Added guidance on utility of IL6 levels
  • 8/17/2021
    • Updated recommendations on use of colchicine in non-hospitalized patients and addressed inpatient use
    • Updated ivermectin studies-no change to overall recommendation for use
    • Updated baricitinib drug information to warn against initiation for low ALC, ANC, or Hgb
  • 8/24/2021
    • Edited information on baricitinib labs for imitation of therapy (ALC <200 cells/µL instead of <500 cells/µL)
  • 8/30/2021
    • Edited information to include tofacitinib and sarilumab as alternatives to baricitinib and tocilizumab in cases of supply issue
  • 10/04/2021
    • Updated monoclonal antibody information to reflect renewed availability of bamlanivimab/etesevimab and to incorporate post-exposure prophylaxis
  • 11/16/2021
    • Edited inpatient anticoagulation algorithm
    • Added chart on preferred outpatient therapies
    • Added information on fluvoxamine


  1. Gordon CJ, Tchesnokov EP, Feng JY, Porter DP, Gotte M. The antiviral compound remdesivir potently inhibits RNA-dependent RNA polymerase from Middle East respiratory syndrome coronavirus. J Biol Chem 2020;24:013056.
  2. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro: Cell Res. Mar;30(3):269-271. doi: 10.1038/s41422-020-0282-0. Epub 2020 Feb 4.; 2020.
  3. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020;382:929-36.
  4. Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists. BMJ 2020;368:m1086. doi: (Published 17 March 2020)
  5. Colson P, Rolain J-M, Raoult D. Chloroquine for the 2019 novel coronavirus SARS-CoV-2. International Journal of Antimicrobial Agents 2020;55:105923.
  6. EMA gives advice on the use of non-steroidal anti-inflammatories for COVID-19. European Medicines Agency. Accessed 3/19/2020.
  7. Cao R, Wang Y, Wen D et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 Mar 18; DOI: 10.1056/NEJMoa2001282.
  8. Gilead Sciences, Inc. Remdesivir (RDV; GS-5734) for the Treatment of Selected Coronavirus (CoV)Infection: Single Patient Protocol, 25 Feb 2020.
  9. Gilead Sciences, Inc. Remdesivir (GS-5734TM) Investigator’s Brochure. Ebola Virus Disease, Marburg Virus Disease, Corona Virus Disease. Edition 5. 21 Feb 2020.
  10. Holshue ML, DeBolt C, Lindquist S, Washington State 2019-nCoV Case Investigation Team. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020 Mar 5;382(10):929-936.
  11. Midgley CM, The COVID-19 Investigation Team. First 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Prepub ahead of print, 2020. DOI: Accessed 18 Mar 2020 from
  12. Alhazzani W, Moller MH, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Medicine. 2020 Mar 20. DOI: 10.1007/s00134-020-06022-5
  13. Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19 [published online ahead of print, 2020 Mar 10]. J Crit Care. 2020;S0883-9441(20)30390-7. doi:10.1016/j.jcrc.2020.03.005
  14. Erin K McCreary, PharmD, BCPS, BCIDP, Jason M Pogue, PharmD, BCPS, BCIDP, on behalf of the Society of Infectious Diseases Pharmacists, COVID-19 Treatment: A Review of Early and Emerging Options, Open Forum Infectious Diseases, ofaa105,
  15. Gautret P, Lagier JC, Parola P et al. Hydroxychloroquine and azithromycin as treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents.2020 Mar 17. DOI: 10.1016/j.ijantimicag.2020.105949
  16. Shang L, Zhao J, Hu Y, Du R, Cao B. On the use of corticosteroids for 2019-nCoV pneumonia. Lancet (London, England). 2020;395(10225):683-684.
  17. National Health Commission (NHC) of the People’s Republic of China. The diagnosis and treatment guide of COVID-19 pneumonia caused by new coronavirus infection 7th Edition, published March 3rd, 2020. Translated to English.
  18. Li Y, Xie Z, Lin W, et al. An exploratory randomized, controlled study on the efficacy and safety of lopinavir/ritonavir or arbidol treated adult patients hospitalized with mild/moderate COVID-19 (ELACOI). medRxiv. 2020 March 28.
  19. Gautret P, Lagier JC, Parola P, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study. Accessed March 30, 2020.
  20. Wu C, X Chen, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020 Mar 13. doi: 10.1001/jamainternmed.2020.0994. [Epub ahead of print]
  21. FDA guidance for use of hydroxychloroquine for COVID-19. Available at Accessed 4/13/2020
  22. Giudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ. Urgent guidance for navigating and circumventing the QTc prolonging and torsadogenic potential of possible pharmacotherapies for COVID-19. Mayo Clinic Proceedings. 2020 Mar 25.
  23. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19 infection. IDSA. 2020 Apr 11. Available at: Accessed 4/12/2020
  24. Iba T, Levy JH, Warkentin TE, et al. Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost. 2019;17(11):1989–1994.
  25. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis [published online ahead of print, 2020 Mar 13]. Clin Chim Acta. 2020;506:145–148.
  26. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844–847.
  27. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [published correction appears in Lancet. 2020 Mar 28;395(10229):1038] [published correction appears in Lancet. 2020 Mar 28;395(10229):1038]. Lancet. 2020;395(10229):1054–1062.
  28. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30;:]. Lancet. 2020;395(10223):497–506.
  29. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy [published online ahead of print, 2020 Mar 27]. J Thromb Haemost. 2020;10.1111/jth.14817.
  30. Lin N, Lu L, Cao W, Li T. Hypothesis for potential pathogenesis of SARS-CoV-2 infection – a review of immune changes in patients with viral pneumonia. EmergMicrobes Infect. 2020.
  31. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathies in COVID-19. J Thromb Haemost. 2020;10.1111/JTH.14810.
  32. Akay O. The double hazard of bleeding and thrombosis in hemostasis from a clinical point of view: A global assessment by Rotational Thromboelasotmetry (ROTEM). Clinical and Applied Thrombosis/Hemostasis 2018; 24(6); 850-8
  33. Hincker A et al. Rotational thromboelastometry predicts thromboembolic complications after major non-cardiac surgery. Critical Care 2014; 18: 549-56
  34. Thorson C et al. Pre-existing hypercoagulability in patients undergoing potential curative cancer resection. Surgery 2014; 155: 134-44
  35. Harahsheh Y et al. Use of viscoelastic tests to predict clinical thromboembolic events: a systematic review and meta-analysis. Eur J Haematol. 2018; 100: 113-23
  36. Davies N.A et al. Application of ROTEM to assess hypercoagulability in patients with lung cancer. Thrombosis Research 2015; 135: 1075-80
  37. Chelbowski M.C et al. Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO. Critical Care 2020; 24: 19-30
  38. Gorton et al. Which TEG variable for monitoring low molecular weight heparin? Anesthesiology 1999; 90: A36
  39. Schott U et al. Thromboelastometry versus free-oscillation rheometry and enoxaparin versus tinzaparin: an in-vitro study comparing two viscoelastic haemostatic tests’ dose-responses to two low molecular weight heparins at the time of withdrawing epidural catethers from major surgery. BMC Anesthesiology 2015; 15: 170-80
  40. Alhazzani W, Moller MH, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Medicine. 2020 Mar 28.
  41. World Health Organization, Clinical Management of Severe Acute Respiratory Infecting when Novel Coronavirus (nCoV) Infection is Suspected.
  42. when-novel-coronavirus-(nCoV)-infection-is-suspected. Accessed 4/8/2020
  43. Centers for Disease Control and Prevention. Healthcare professionals: frequently asked questions and answers. Available at: [ ncov/hcp/fac.html]( ncov/hcp/fac.html). Accessed April 7, 2020.
  44. Zhou W, Liu Y, Tian D, et al. Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia. Signal Transduction and Targeted Therapy. 2020 Feb 21.
  45. Zheng C, Want J, Guo H, et al. Risk-adapted treatment strategy for COVID-19 patients. International Journal of Infectious Diseases. 2020 Mar 23.
  46. Zhou F, Yu, T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 9.
  47. NCCN Guidelines. Management of Immunotherapy-Related Toxicities. Version 1.2020.
  48. Grein J, Ohmagari N, Shin D, Diaz G, et al. Compassionate use of remdesivir for patients with severe COVID-19. NEJM. 2020 Apr 23. doi:10.1056/NEJMoa2007016
  49. Mahevas M, Tran V, Roumier M, Charbrol A, et al. No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection and requiring oxygen: results of a study using routinely collected data to emulate a target trial. medRxiv preprint.
  50. Lane J, Weaver J, Kostka K, Duarte-Salles T, et al. Safety of hydroxychloroquine, alone and in combination with azithromycin, in light of wide-spread use for COVID-19: a multi- national, network cohort and self-controlled case series study. medRxiv preprint.
  51. Xue J, Moyer A, Beng P, Wu J, Hannafon B, Ding WQ. Chloroquine is a zinc inophore. Plos One. 2014;9(10): e109180
  52. NIH COVID-19 treatment guidelines. NIH. Available at: Accessed 4/22/2020
  53. Ji, H. L., Zhao, R., Matalon, S., & Matthay, M. A. (2020). Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility. Physiol Rev, 100(3), 1065-1075. doi:10.1152/physrev.00013.2020
  54. Poor, H. D., Ventetuolo, C. E., Tolbert, T., Chun, G., Serrao, G., Zeidman, A, Powell, C. A. (2020). COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis. doi:10.1101/2020.04.17.20057125
  55. Wang, J., Hajizadeh, N., Moore, E. E., McIntyre, R. C., Moore, P. K., Veress, L. A., Barrett, C. D. (2020). Tissue Plasminogen Activator (tPA) Treatment for COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS): A Case Series. J Thromb Haemost. doi:10.1111/jth.14828
  56. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at Accessed May 13, 2020.
  57. Joyner MJ, Wright RS, Fairweather D, et al. Early safety indicators of COVID-19 convalescent plasma in 5,000 patients. medRxiv preprint doi:
  58. Mayo Clinic IRB. Expanded access to convalescent plasma for the treatment of patients with COVID-19. Available at: Accessed 5/18/2020.
  59. Goldman JD, Lye DC, Hui DS, et al. Remdesivir for 5 or 10 days in patients with severe COVID-19. NEJM. 2020 doi: 10.1056/NEJM/Moa2015301
  60. University of Oxford. RECOVERY trial: randomized evaluation of COVID-19 therapy. Available at: Accessed 6/17/2020.
  61. Arshad A, Kilgor P, Chaudhry Z, et al. Treatment with hydroxychloroquine, azithromycin and in combination for patients hospitalized with COVID-19. Int J Infect Dis. June 29, 2020.
  62. Davis M, McCreary E, Pogue J. That escalated quickly: remdesivir’s place in therapy for COVID-19. Infect Dis Ther. June 9, 2020.
  63. Jorgensen S, Kebriaei R, Dresser LD, et al. Remdesivir: review of pharmacology, pre-clinical data, and emerging clinical experience for COVID-19. Pharmacotherapy. doi: 10.1002/phar.2429.
  64. Remdesivir. COVID-19 Treatment Guidelines. NIH. July 24, 2020. Available at:
  65. Corticosteroids. COVID-19 Treatment Guidelines. NIH. July 30, 2020. Available at:
  66. Olender S, Perez K, Balani B, et al. Remdesivir for severe covid-19 versus cohort receiving standard of care. Clin Infect Dis. July 24, 2020.
  67. U.S. Food and Drug Administration. FDA issues emergency use authorization for convalescent plasma as potential promising COVID-19 treatment, another achievement in admiinistration’s fight against pandemic. August 23, 2020. Available at:
  68. Spinner C, Gottlieb RL, Criner GL, et al. Effect of remdesivir vs standard of care on clinical status at 11 days in patients with moderate COVID-19: a randomized controlled trial. JAMA. 2020. Available at:
  69. Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of COVID-19-Final report. NEJM. 2020 DOI: 10.1056/NEJMoa2007764
  70. WHO Solidarity Trial Consortium. Repurposed antiviral drugs for COVID-19-interim WHO solidarity results. medRxiv. 2020. Available at:
  71. Stone JH, Frigault MJ, Serling-Boyd, NJ, et al. Efficacy of tocilizumab in patients hospitalized with COVID-19. NEJM. 2020. DOI: 10.1056/NEJMoa2028836
  72. Chen P, Nirula A, Heller B, et al; BLAZE-1 Investigators. SARS-CoV-2 Neutralizing Antibody LY-CoV555 in Outpatients with Covid-19. N Engl J Med. 2020 Oct 28. doi: 10.1056/NEJMoa2029849. Epub ahead of print.
  73. COVID-19 Treatment Guidelines Panel. The COVID-19 Treatment Guidelines Panel’s Statement on the Emergency Use Authorization of Bamlanivimab for the Treatment of COVID-19 National Institutes of Health. Available at []
  74. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19 infection. IDSA. Available at:, Accessed 11.19.2020
  75. Baricitinib Emergency Use Authorization. November 24, 2020. Available at:
  76. Adaptive COVID-19 Treatment Trial 2 (ACTT-2)-Baricitinib. November 24, 2020. Available at:
  77. Casirivimab and Imdevimab. Emergency Use Authorization. Available at: Casirivimab and Imdevimab (
  78. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 [published online ahead of print, 2020 Dec 11]. N Engl J Med. 2020;NEJMoa2031994. doi:10.1056/NEJMoa2031994.
  79. WHO Solidarity Trial Consortium, Pan H, Peto R, et al. Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results [published online ahead of print, 2020 Dec
    2]. N Engl J Med. 2020;NEJMoa2023184. doi:10.1056/NEJMoa2023184
  80. Tardif, JC, et al. Efficacy of colchicine in non-hospitalized patients with COVID-19. medRxiv. 2021. Available at: Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19
  81. Nopp S, Moik F, Jilma B, Pabinger I, Ay C. Risk of venous thromboembolism in patients with COVID-19: a systematic review and meta-analysis. Res Pract Thromb Haemost. 2020.
  82. Paranjpe I, Fuster V, Lala A, et al. Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19. Journal of the American College of Cardiology. 2020;In press.
  83. Lemos ACB, do Espirito Santo DA, Salvetti MC, et al. Therapeutic versus prophylactic anticoagulation for severe COVID-19: a randomized Phase II clinical trial (HESACOVID). Thromb Res. 2020;196:359-366.
  84. Antithrombotic Therapy in Patients With COVID-19. Available at: Accessed February 23, 2021.
  85. ATTACC, ACTIV-4a & REMAP-CAP multiplatform RCT- Results of Interim Analysis. Available at: Accessed February 23, 2021.
  86. Cuker A, Tseng EK, Nieuwlaat R, et al. American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19. Blood Adv. 2021;5(3):872-888.
  87. Moores LK, Tritschler T, Brosnahan S, et al. Prevention, diagnosis, and treatment of vte in patients with coronavirus disease 2019: chest guideline and expert panel report. Chest. 2020;158(3):1143-1163.
  88. WHO COVID-19 Clinical management living guidance. January 25, 2021.
  89. Billett HH, Reyes-Gil M, Szymanski J, et al. Anticoagulation in covid-19: effect of enoxaparin, heparin, and apixaban on mortality. Thromb Haemost. 2020;120(12):1691-1699.
  90. Meizlish ML, Goshua G, Liu Y, et al. Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis. Am J Hematol. Published online January 21, 2021.
  91. Ionescu F, Jaiyesimi I, Petrescu I, et al. Association of anticoagulation dose and survival in hospitalized COVID-19 patients: A retrospective propensity score-weighted analysis. Eur J Haematol. 2021;106(2):165-174.
  92. Rentsch CT, Beckman JA, Tomlinson L, et al. Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study. BMJ. 2021;372:n311. Published 2021 Feb 11. doi:10.1136/bmj.n311
  93. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, Edwards KM, Gandhi R, Gallagher J, Muller WJ, O'Horo JC, Shoham S, Murad MH, Mustafa RA, Sultan S, Falck-Ytter Y. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Infectious Diseases Society of America 2021; Version 4.3.0. Available at Accessed 8 June 2021.
  94. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at Accessed 8 June 2021.
  95. Kaka AS, MacDonald R, Greer N, et al. Major Update: Remdesivir for Adults With COVID-19 : A Living Systematic Review and Meta-analysis for the American College of Physicians Practice Points [published correction appears in Ann Intern Med. 2021 Mar 16;:]. Ann Intern Med. 2021;174(5):663-672. doi:10.7326/M20-8148
  96. Marconi V, Ramanan A, de Bono S, et al. Efficacy and safety of baricitinib in patients with COVID-19 infection: Results from the randomised, double-blind, placebo-controlled, parallel-group COV-BARRIER phase 3 trial_. medRxiv_ 2021.04.30.21255934; doi:
  97. Actemra. Fact Sheet for Healthcare Providers: Emergency Use Authorization for Actemra (tocilizumab). Genentech Inc; 2021.
  98. RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021;397(10285):1637-1645. doi:10.1016/S0140-6736(21)00676-0
  99. WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Shankar-Hari M, Vale CL, et al. Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis [published online ahead of print, 2021 Jul 6]. JAMA. 2021;e2111330. doi:10.1001/jama.2021.11330
  100. Veklury. Package insert. Gilead Sciences, Inc; 2021.
  101. Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 7-10 June 2021. 11 June 2021. Available at:
  102. Touafchia A, Bagheri H, Carrié D, et al. Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns [published online ahead of print, 2021 Feb 27]. Clin Microbiol Infect. 2021;27(5):791.e5-791.e8. doi:10.1016/j.cmi.2021.02.013
  103. Pallotto C, Blanc P, Esperti S, et al. Remdesivir treatment and transient bradycardia in patients with coronavirus diseases 2019 (COVID-19) [published online ahead of print, 2021 May 28]. J Infect. 2021;S0163-4453(21)00267-X. doi:10.1016/j.jinf.2021.05.025
  104. Gubitosa JC, Kakar P, Gerula C, et al. Marked Sinus Bradycardia Associated With Remdesivir in COVID-19: A Case and Literature Review. JACC Case Rep. 2020;2(14):2260-2264. doi:10.1016/j.jaccas.2020.08.025
  105. Jacinto JP, Patel M, Goh J, Yamamura K. Remdesivir-induced Symptomatic Bradycardia in the treatment of COVID-19 Disease [published online ahead of print, 2021 May 15]. HeartRhythm Case Rep. 2021;10.1016/j.hrcr.2021.05.004. doi:10.1016/j.hrcr.2021.05.004
  106. Barkas F, Styla CP, Bechlioulis A, Milionis H, Liberopoulos E. Sinus Bradycardia Associated with Remdesivir Treatment in COVID-19: A Case Report and Literature Review. J Cardiovasc Dev Dis. 2021;8(2):18. Published 2021 Feb 12. doi:10.3390/jcdd8020018
  107. O’Brien MP, Forleo-Neto BJ, Musser FI, et al. Subcutaneous REGEN-COV antibody combination to prevent COVID-19. NEJM. 2021. DOI: 10.1056/NEJMoa2109682

Adapted from the AdventHealth Orlando Antimicrobial Stewardship Program