Guidelines
COVID-19

COVID-19

Note:

This guideline reviews the management of adult patients. For pediatric information, refer to IWK guidelines (via Firstline).

Background

Clinical Management of COVID-19

  • CBC
  • Electrolytes (Na, K, Cl, Ca, Mg)
  • Glucose
  • CO₂
  • Serum creatinine
  • Liver function test (ALT, AST, LDH, alkaline phosphatase, bilirubin)
  • CRP, procalcitonin
  • Ferritin
  • COAG, D-Dimer
  • Serum Beta-hCG (if woman of childbearing age)
  • Chest x-ray
  • ECG
  • If fever/sepsis syndrome:
    • Blood cultures x 2 sets
    • Sputum culture (if patient can produce sputum)
    • Pneumococcal and Legionella urinary antigen tests

More Information

  • Guideline and content adapted from the Fraser Health Antimicrobial Stewardship Program, Nova Scotia Health Authority Antimicrobial Stewardship Program, IWK Health Centre, the Saskatchewan Health Authority, and Horizon Health Network.
  • Revised: 2022-08-05

Criteria for use of Anti-SARS-CoV-2 Monoclonal Antibodies for Hospitalized Patients with Severe or Critical COVID-19:

  1. RECOVERY Collaborative Group. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Preprint uploaded to MedRxiv June 16, 2021. doi: https://doi.org/10.1101/2021.06.15.21258542
  2. Hoffmann-La Roche. Casirivimab and imdevimab - Product Monograph. https://covid-vaccine.canada.ca/info/pdf/casirivimab-imdevimab-pm-en.pdf. Accessed online 21/10/2021
  3. Jacob J. Bailey, Andrew M. Morris, Sally Bean, Eyal Cohen, Jonathan Gubbay, Yona Lunsky, Samir Patel, Vanessa Tran, Katherine J. Miller, Zainab Abdurrahman, Stephanie Carlin, William Ciccotelli, Jennifer Gibson, Tiffany Kan, Bradley Langford, Elizabeth Leung, Ullanda Neil, Sumit Raybardan, Janet Smylie, Anupma Wadhwa, Peter Jüni, Menaka Pai, on behalf of the Ontario COVID-19 Science Advisory Table and the Drugs & Biologics Clinical Practice Guidelines Working Group. Evidence-Based Recommendations on the Use of Casirivimab + Imdevimab, and Sotrovimab for Adults in Ontario. Version 2.0  https://doi.org/10.47326/ocsat.2021.02.45.1.0. Updated on November 24, 2021
  4. The COVID-19 Therapeutics Working Group, Alberta Health Services. Treatment Guidance for the Management of Adult Hospitalized Patients with COVID-19. Last updated: November 8, 2021 
  5. Centers for Disease Control and Prevention. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. (last updated September 27, 2021). https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. Accessed online 21/10/2021 
  6. REGEN-COV® for Treatment of Hospitalized Patients with Covid-19.  Selin Somersan-Karakaya, Eleftherios Mylonakis, Vidya P. Menon, Jason C. Wells, Shazia Ali, Sumathi Sivapalasingam, Yiping Sun, Rafia Bhore, Jingning Mei, Jutta Miller, Lisa Cupelli, Andrea T. Hooper, Jennifer D. Hamilton, Cynthia Pan, Viet Pham, Yuming Zhao, Romana Hosain, Adnan Mahmood, John D. Davis, Kenneth C. Turner, Yunji Kim, Amanda Cook, Bari Kowal, Yuhwen Soo, A. Thomas DiCioccio, Gregory P. Geba, Neil Stahl, Leah Lipsich, Ned Braunstein, Gary A. Herman, George D. Yancopoulos, David M. Weinreich, for the Covid-19 Phase 2/3 Hospitalized Trial Team medRxiv 2021.11.05.21265656; doi: https://doi.org/10.1101/2021.11.05.21265656
  7. BC COVID Therapeutics Committee (CTC).  Clinical Practice Guide for the Use of REGEN-COV in Inpatients with COVID-19. V1_18 November 2021.  http://www.bccdc.ca/Health-Professionals-Site/Documents/ClinicalPracticeGuideREGENCOVInpatient.pdf