The World Health Organization (WHO) has updated its COVID-19 guidelines on treatments, isolation periods and mask wearing.
Included in the advice is a strong recommendation for the use of Pfizer’s Paxlovid (nirmatrelvir/ritonavir) in mild or moderate COVID-19 patients who are at high risk of hospitalisation.
Pregnant or breastfeeding women with non-severe COVID-19 should consult with their doctor to determine whether they should take the orally administered drug, WHO said, which cited its ‘likely benefits’ and a lack of adverse events which have been reported.
WHO also reviewed the evidence on two other medicines, GSK/Vir Biotechnology’s Xevudy (sotrovimab) and Regeneron/Roche’s REGEN-COV (casirivimab/imdevimab), and maintains strong recommendations against their use for treating COVID-19.
The organisation said the updated guidelines were “part of a continuous process of reviewing such materials, working with guideline development groups composed of independent, international experts who consider the latest available evidence and the changing epidemiology”.
The guidelines also recommend a reduced isolation period, with WHO advising that a COVID-19 patient can be discharged from isolation early if they test negative on an antigen-based rapid test.
Without testing, for patients with symptoms, the new guidance suggests ten days of isolation from the date of symptom onset. Previously, WHO advised that patients be discharged ten days after symptom onset, plus at least three additional days since their symptoms had resolved.
Additionally, for those who test positive for COVID-19 but do not have any signs or symptoms, WHO now suggests five days of isolation in the absence of testing, compared to ten days previously.
In terms of wearing masks, the use of masks by the public in specific situations has been recommended in the update, irrespective of the local epidemiological situation, which is previously what WHO’s recommendations were based on.
Masks are now recommended following recent exposure to COVID-19, when someone has or suspects they have COVID-19, when someone is at high risk of severe COVID-19, and for anyone in a crowded, enclosed or poorly ventilated space.
The latest advice follows the XBB.1.5 subvariant being detected in Europe in small but growing numbers, WHO and Europe officials said at a press briefing.
XBB.1.5, which is another descendant of the Omicron variant, is “the most transmissible subvariant that has been detected yet”, WHO COVID-19 technical lead, Maria Van Kerkhove, said at a press conference earlier this month, when the subvariant was reported to be spreading rapidly in the US.