COVID-19

Also known as: coronavirus · SARS-CoV-2

Also relevant to Respiratory

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United StatesIDSA/CDC

Current

IDSA Guidelines on the Treatment and Management of Patients with COVID-19

Infectious Diseases Society of America (IDSA) · 2025 · Living guideline, updated October 2025

A living IDSA guideline giving evidence-based recommendations on pharmacologic treatment of COVID-19 across severity levels, including antivirals, immunomodulators and pre-exposure prophylaxis options.

Recommendations are stratified by disease severity and individual risk of progression, covering agents such as nirmatrelvir/ritonavir, remdesivir and molnupiravir. source
The panel notes that most recommendations are conditional rather than strong because of remaining evidence gaps and evolving variants. source

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EuropeESCMID/ECDC

CurrentGlobal guideline

Clinical management of COVID-19: living guideline

World Health Organization (WHO) · 2025 · Version 8 (June 2025)

WHO's living guideline on the clinical care of patients with COVID-19, covering the care pathway from suspected infection through severe and critical illness. This eighth version replaces the 2023 edition.

The June 2025 version adds two recommendations on antibiotic use in patients with non-severe and severe COVID-19 where bacterial co-infection is considered unlikely. source
WHO maintains separate companion living guidelines on COVID-19 therapeutics and on drugs for prevention. source

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US vs EU key differences

Scope is partitioned differently: WHO splits supportive and clinical care into a 'Clinical management of COVID-19' living guideline and keeps drug recommendations in a separate 'Therapeutics and COVID-19' living guideline, while the IDSA guideline is organised around treatment and management together. source
The June 2025 WHO clinical management update adds explicit antibiotic-stewardship recommendations — against empirical antibiotics in non-severe COVID-19 with low suspicion of bacterial infection (strong) and a conditional suggestion against them in severe disease. source
The 2025 IDSA update focuses on outpatient antivirals for mild-to-moderate COVID-19 in adults, issuing nine recommendations covering nirmatrelvir/ritonavir, remdesivir and molnupiravir stratified by risk of progression. source

What changed recently

US2023 guideline → Living guideline, updated October 20252025-10-14
The October 2025 antiviral update reframed treatment decisions around preventing hospitalisation rather than death, given higher population immunity. It keeps a strong recommendation for nirmatrelvir/ritonavir in adults at high risk of progression but now suggests against routine antiviral treatment in mild to moderate COVID-19 without risk factors.
source ↗curation confidence 80%
GLOBALVersion 7 → Version 8 (June 2025)2025-06-01
Version 8 added two new antibiotic-stewardship recommendations drawn from a meta-analysis of antibiotic use in COVID-19: withhold empirical antibiotics in non-severe COVID-19 when bacterial co-infection is clinically unlikely (strong), and likewise suggest withholding them in severe COVID-19 with low suspicion of co-infection (conditional).
source ↗curation confidence 90%

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