Guidelines
Low-Flow O2 Requirement

Low-Flow O2 Requirement

Treatment Options

Treatment Comments
Steroids Dexamethasone 6 mg IV/PO daily up to 10 days
Remdesivir* 200 mg IV x 1 dose, followed by 100 mg IV daily x 4 days
Baricitinib Consider if steroids contraindicated

*It is unclear whether Remdesivir is beneficial >7 days beyond symptom onset in immunocompetent patients.

*Therapy should be stopped after 3 days if patient no longer requires oxygen

Worsening oxygenation (> 6 L/min) despite the above

Treatment Comments
High-dose steroids* Methylprednisolone 1-2 mg/kg/day divided q8-12, OR, Dexamethasone 20 mg daily x 5 days, followed by 6-10 mg daily for 10 days

*Insufficient evidence to recommend one steroid over the other

No improvement after 48-72 hrs, consider one of the following

Treatment Comments
Baricitinib 4 mg daily up to 14 days
Tocilizumab* x 1 (If pt meets inclusion criteria**)

*EUA status, requires documentation of EUA criteria in a progress note

**HFNC, acute BiPAP/CPAP, or mechanical ventilation; CRP ≥ 7.5 mg/dL (w/in past 24 hr); on corticosteroids

DVT Prophylaxis is Recommended if No Contraindications

Enoxaparin (1st line)

OR

Heparin subcutaneous (2nd line)