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Still Treating Yesterday's Risk? Reconsidering Antiviral Use for Mild-to-Moderate COVID-19 Cases in a Broadly Immune
Hadar Mudrik-Zohar1,2,3, Tim Cutfield4,5, Susan Morpeth4,5
1Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
None:
Antivirals for mild-to-moderate coronavirus disease 2019 (COVID-19) were adopted for use based on trials in unvaccinated adults during the pre-Omicron period. In today's broadly immune populations, where the risk of hospitalisation and death has decreased substantially, there is a lack of high-quality contemporary evidence to support routine antiviral use for mild-to-moderate disease. Comparing the Australian and New Zealand experiences in the evolving COVID-19 landscape highlights differences in policy and prescribing practice. Treatment guidelines should be informed by systematic evaluation of emerging data, given uncertainty regarding antiviral effectiveness in a context of widespread immunity and milder disease, which have altered the balance of risks and benefits.
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