Guideline

Therapeutics and COVID-19: living guideline, August 2025

Year of Publication

2025

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

31 included recommendations

The World Health Organization (WHO) recommends against administering hydroxychloroquine or chloroquine for treatment of patients with COVID-19. This recommendation applies to patients with any disease severity and any duration of symptoms.

Status

Maintained

Recommended against

Strong

Certainty of evidence

Low

The World Health Organization (WHO) recommends against administering lopinavir/ritonavir for treatment of COVID-19. This recommendation applies to patients with any disease severity and any duration of symptoms.

Status

Maintained

Recommended against

Strong

Certainty of evidence

Low

We suggest treatment with remdesivir for patients with non-severe COVID-19 at highest risk of hospitalization

Status

Maintained

Recommended against

Conditional

The World Health Organization (WHO) recommends systemic corticosteroids for patients with severe and critical COVID-19 infection.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Low

The World Health Organization (WHO) suggests not to use corticosteroids for patients with non-severe COVID-19 infection.

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Low

For patients with non-severe COVID-19 (who do not meet criteria for severe or critical infection). The WHO recommends against administering convalescent plasma for treatment of COVID-19

Status

Maintained

Recommended against

Strong

Certainty of evidence

Moderate

For patients with severe or critical COVID-19. The WHO recommends not to use convalescent plasma for treatment of COVID-19, except in the context of a clinical trial

Status

Maintained

Recommended against

Strong

Certainty of evidence

Low

We recommend against treatment with casirivimab-imdevimab for all patients with COVID-19

Status

Maintained

Recommended against

Strong

The World Health Organization (WHO) recommends treatment with IL-6 receptor blockers (tocilizumab or sarilumab) for patients with severe or critical COVID-19 infection.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

We recommend not to use ivermectin in patients with severe or critical COVID-19, except in the context of a clinical trial

Status

Maintained

Recommended against

Strong

Certainty of evidence

Very low

The World Health Organisation (WHO) recommend treatment with baricitinib for patients with severe or critical COVID-19. Corticosteroids and IL-6 receptor blockers (tocilizumab and sarilumab) are also recommended, and may be administered in combination with baricitinib to patients with severe or critical COVID-19

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

The World Health Organisation (WHO) suggest not to use ruxolitinib or tofacitinib for patients with severe or critical COVID-19

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

We recommend against treatment with sotrovimab for patients with non-severe COVID-19

Status

Maintained

Recommended against

Strong

Certainty of evidence

Very low

We suggest treatment with molnupiravir for patients with non-severe COVID-19 at high risk of hospitalization

Status

Maintained

Recommended in favor

Conditional

We recommend treatment with nirmatrelvir-ritonavir for patients with non-severe COVID-19 at high risk of hospitalization

Status

Maintained

Recommended in favor

Strong

We suggest not to use treatment with nirmatrelvir-ritonavir for patients with non-severe COVID-19 at low risk of hospitalization

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

For patients with non-severe COVID-19, we recommend not to use fluvoxamine, except in the context of a clinical trial

Status

Maintained

Recommended against

Strong

For patients with non-severe COVID-19, we recommend against treatment with colchicine

Status

Maintained

Recommended against

Strong

We suggest treatment with remdesivir for patients with severe COVID-19

Status

Maintained

Recommended in favor

Conditional

We suggest not to use remdesivir for patients with critical COVID-19

Status

Maintained

Recommended against

Conditional

We recommend against treatment with molnupiravir for patients with non-severe COVID-19 at low risk of hospitalization

Status

Maintained

Recommended against

Strong

We recommend not to use remdesivir for patients with non-severe COVID-19 at low risk of hospitalization

Status

Maintained

Recommended against

Strong

We recommend not to use ivermectin for patients with non-severe COVID-19

Status

Maintained

Recommended against

Strong

We recommend not to use VV116, for patients with COVID-19, regardless of disease severity except in the context of a clinical trial

Status

Updated

Recommended against

Strong

Certainty of evidence

Very low

We suggest to use treatment with nirmatrelvir-ritonavir for patients with non-severe COVID-19 at moderate risk of hospitalization

Status

Maintained

Recommended in favor

Conditional

We suggest not to use treatment with remdesivir for patients with non-severe COVID-19 at moderate risk of hospitalization

Status

Maintained

Recommended against

Conditional

We suggest against treatment with molnupiravir for patients with non-severe COVID-19 at moderate risk of hospitalization

Status

Maintained

Recommended against

Conditional

We suggest administering prophylactic dose heparin instead of therapeutic or intermediate dose heparin for severe or critical COVID-19 (heparin includes unfractionated or low molecular weight heparin)

Status

New

Recommended in favor

Conditional

We recommend not to use statins for severe or critical COVID-19 This recommendation does not apply to individuals already receiving a statin for an alternate indication.

Status

New

Recommended against

Strong

We recommend not to use SGLT-2 inhibitors for severe or critical COVID-19 . This recommendation does not apply to individuals already receiving an SGLT-2 inhibitor for an alternate indication.

Status

New

Recommended against

Strong

We suggest not to use metformin in the acute management of COVID-19

Status

New

Recommended against

Conditional