COVID-19 pandemic

=== Treatment ===
{{Main|Treatment and management of COVID-19}}
[[File:Respiradores da USP utilizados do Incor (50119127303).jpg|thumb|A critically ill patient receiving invasive ventilation in the intensive care unit of the [[Heart Institute, University of São Paulo]] in July 2020. Due to a shortage of mechanical ventilators, a [[resuscitator|bridge ventilator]] is being used to automatically actuate a [[bag valve mask]].]]
For the first two years of the pandemic, no specific and effective treatment or cure was available.<ref name="BMJLivingReview">{{#invoke:cite journal || vauthors = Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, Pardo-Hernandez H, Qasim A, Martinez JP, Rochwerg B, Lamontagne F, Han MA, Liu Q, Agarwal A, Agoritsas T, Chu DK, Couban R, Cusano E, Darzi A, Devji T, Fang B, Fang C, Flottorp SA, Foroutan F, Ghadimi M, Heels-Ansdell D, Honarmand K, Hou L, Hou X, Ibrahim Q, Khamis A, Lam B, Loeb M, Marcucci M, McLeod SL, Motaghi S, Murthy S, Mustafa RA, Neary JD, Rada G, Riaz IB, Sadeghirad B, Sekercioglu N, Sheng L, Sreekanta A, Switzer C, Tendal B, Thabane L, Tomlinson G, Turner T, Vandvik PO, Vernooij RW, Viteri-García A, Wang Y, Yao L, Ye Z, Guyatt GH, Brignardello-Petersen R | title = Drug treatments for covid-19: living systematic review and network meta-analysis | journal = BMJ | volume = 370 | pages = m2980 | date = 31 March 2021 | pmid = 32732190 | pmc = 7390912 | doi = 10.1136/bmj.m2980 }}</ref><ref name="cdcmuseum">{{#invoke:cite web ||title=CDC Museum COVID-19 Timeline |url=https://www.cdc.gov/museum/timeline/covid19.html |website=Centers for Disease Control and Prevention |access-date=27 May 2023 |date=15 March 2023}}</ref> In 2021, the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) approved the oral antiviral [[Protease inhibitor (pharmacology)|protease inhibitor]], [[Paxlovid]] (nirmatrelvir plus the HIV antiviral [[ritonavir]]), to treat adult patients.<ref>{{#invoke:cite news||date=17 December 2021|title=EMA CHMP advises use of Pfizer's Covid-19 oral antiviral Paxlovid|url=https://www.pharmaceutical-technology.com/news/ema-chmp-pfizer-paxlovid/|url-status=live|access-date=18 December 2021|newspaper=Pharmaceutical Technology|archive-url=https://web.archive.org/web/20211218175759/https://www.pharmaceutical-technology.com/news/ema-chmp-pfizer-paxlovid/ |archive-date=18 December 2021 |last1=Priyan |first1=Vishnu }}</ref> FDA later gave it an EUA.<ref>{{#invoke:cite web||title=Paxlovid LOA 12222021 {{!}} FDA|url=https://www.fda.gov/media/155049|access-date=23 December 2021|website=www.fda.gov}}</ref>

Most cases of COVID-19 are mild. In these, supportive care includes medication such as [[paracetamol]] or [[NSAID]]s to relieve symptoms (fever,<ref>{{#invoke:cite journal || vauthors = Islam MA, Kundu S, Alam SS, Hossan T, Kamal MA, Hassan R | title = Prevalence and characteristics of fever in adult and paediatric patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis of 17515 patients | journal = PLOS ONE | volume = 16 | issue = 4 | pages = e0249788 | date = 6 April 2021 | pmid = 33822812 | pmc = 8023501 | doi = 10.1371/journal.pone.0249788 | s2cid = 233173405 | doi-access = free | bibcode = 2021PLoSO..1649788I }}</ref> body aches, cough), adequate intake of oral fluids and rest.<ref name="cdcmuseum" /><ref>Multiple sources:
* {{#invoke:cite journal || vauthors = Wang Y, Wang Y, Chen Y, Qin Q | title = Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures | journal = Journal of Medical Virology | volume = 92 | issue = 6 | pages = 568–576 | date = June 2020 | pmid = 32134116 | pmc = 7228347 | doi = 10.1002/jmv.25748 | doi-access = free }}
* {{#invoke:cite journal || vauthors = Martel J, Ko YF, Young JD, Ojcius DM | title = Could nasal nitric oxide help to mitigate the severity of COVID-19? | journal = Microbes and Infection | volume = 22 | issue = 4–5 | pages = 168–171 | date = May 2020 | pmid = 32387333 | pmc = 7200356 | doi = 10.1016/j.micinf.2020.05.002 }}
* {{#invoke:cite news || title=Coronavirus recovery: breathing exercises|url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises|access-date=30 July 2020|website=hopkinsmedicine.org|publisher=Johns Hopkins Medicine}}</ref> Good personal hygiene and a [[healthy diet]] are also recommended.<ref>{{#invoke:cite journal || vauthors = Wang L, Wang Y, Ye D, Liu Q | title = Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence | journal = International Journal of Antimicrobial Agents | volume = 55 | issue = 6 | page = 105948 | date = June 2020 | pmid = 32201353 | pmc = 7156162 | doi = 10.1016/j.ijantimicag.2020.105948 }}</ref>

[[Supportive care]] in severe cases includes treatment to [[Symptomatic treatment|relieve symptoms]], [[Fluid replacement|fluid therapy]], [[oxygen support]] and [[prone positioning]], and medications or devices to support other affected vital organs.<ref>Multiple sources:
* {{#invoke:cite journal||vauthors=Fisher D, Heymann D|date=February 2020|title=Q&A: The novel coronavirus outbreak causing COVID-19|journal=BMC Medicine|volume=18|issue=1|page=57|doi=10.1186/s12916-020-01533-w|pmc=7047369|pmid=32106852|doi-access=free}}
* {{#invoke:cite journal||vauthors=Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, Xiao W, Wang YN, Zhong MH, Li CH, Li GC, Liu HG|date=May 2020|title=Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province|journal=Chinese Medical Journal|volume=133|issue=9|pages=1025–1031|doi=10.1097/CM9.0000000000000744|pmc=7147277|pmid=32044814|doi-access=free}}
* {{#invoke:cite journal||vauthors=Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, Jiang B|date=March 2020|title=Comorbidities and multi-organ injuries in the treatment of COVID-19|journal=Lancet|publisher=Elsevier BV|volume=395|issue=10228|pages=e52|doi=10.1016/s0140-6736(20)30558-4|pmc=7270177|pmid=32171074|doi-access=free}}</ref> More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid [[dexamethasone]] is recommended to reduce mortality.<ref>Multiple sources:
* {{#invoke:cite journal || vauthors = | title = Update to living WHO guideline on drugs for covid-19 | journal = BMJ | volume = 371 | pages = m4475 | date = November 2020 | pmid = 33214213 | doi = 10.1136/bmj.m4475 | s2cid = 227059995 | doi-access = free }}
* {{#invoke:cite web || title=Q&A: Dexamethasone and COVID-19|url=https://www.who.int/news-room/q-a-detail/q-a-dexamethasone-and-covid-19|access-date=11 July 2020|publisher=World Health Organization}}
* {{#invoke:cite web || title=Home|url=https://covid19evidence.net.au/|access-date=11 July 2020|website=[[National COVID-19 Clinical Evidence Taskforce]]}}</ref> [[Noninvasive ventilation]] and, ultimately, admission to an [[intensive care unit]] for [[mechanical ventilation]] may be required to support breathing.<ref name="NIHGuidelines2020">{{#invoke:cite web || title=COVID-19 Treatment Guidelines|url=https://www.covid19treatmentguidelines.nih.gov/|access-date=18 January 2021|website=nih.gov|publisher=National Institutes of Health}}</ref> [[Extracorporeal membrane oxygenation]] (ECMO) has been used to address the issue of respiratory failure.<ref name="Guan Ni Hu Liang p.">{{#invoke:cite journal || vauthors = Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS | title = Clinical Characteristics of Coronavirus Disease 2019 in China | journal = The New England Journal of Medicine | volume = 382 | issue = 18 | pages = 1708–1720 | date = April 2020 | pmid = 32109013 | pmc = 7092819 | doi = 10.1056/nejmoa2002032 | publisher = Massachusetts Medical Society | doi-access = free }}</ref><ref name="Henry 2020 p.">{{#invoke:cite journal || vauthors = Henry BM | title = COVID-19, ECMO, and lymphopenia: a word of caution | journal = The Lancet. Respiratory Medicine | volume = 8 | issue = 4 | pages = e24 | date = April 2020 | pmid = 32178774 | pmc = 7118650 | doi = 10.1016/s2213-2600(20)30119-3 | publisher = Elsevier BV }}</ref>

Existing drugs such as [[hydroxychloroquine]], [[lopinavir/ritonavir]], and [[ivermectin]] are not recommended by US or European health authorities, as there is no good evidence they have any useful effect.<ref name="BMJLivingReview" /><ref name="Kim Read Fauci p=2149">{{#invoke:cite journal || vauthors = Kim PS, Read SW, Fauci AS | title = Therapy for Early COVID-19: A Critical Need | journal = JAMA | volume = 324 | issue = 21 | pages = 2149–2150 | date = December 2020 | pmid = 33175121 | doi = 10.1001/jama.2020.22813 | publisher = American Medical Association (AMA) | s2cid = 226301949 | doi-access = free | author-link3 = Anthony Fauci }}</ref><ref name="NIHGuidelinesTherapeuticManagement">{{#invoke:cite web || title=COVID-19 Treatment Guidelines|url=https://www.covid19treatmentguidelines.nih.gov/therapeutic-management|access-date=18 January 2021|website=nih.gov|publisher=National Institutes of Health}}/</ref> The antiviral [[remdesivir]] is available in the US, Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for use with mechanical ventilation, and is discouraged altogether by the [[World Health Organization]] (WHO),<ref name="Hsu p=m4457">{{#invoke:cite journal || vauthors = Hsu J | title = Covid-19: What now for remdesivir? | journal = BMJ | volume = 371 | pages = m4457 | date = November 2020 | pmid = 33214186 | doi = 10.1136/bmj.m4457 | s2cid = 227060756 | doi-access = free }}</ref> due to limited evidence of its efficacy.<ref name="BMJLivingReview" />
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