Does my patient need a PCR test to confirm COVID-19 before prescribing oral antivirals?

PCR testing is not required before prescribing oral antivirals. Oral antiviral drugs are beneficial if begun within 5 days of symptom onset; obtaining PCR confirmation before starting treatment may result in test results arriving past the point of antiviral benefit. To ensure antivirals reach those who would benefit, delays in treatment should be avoided, and PCR confirmation is not necessary. According to the Emergency Use Authorization (EUA) issued by the Federal Drug Administration (FDA), paxlovid and molnupiravir are indicated for individuals diagnosed with COVID-19, whether or not a viral test has been done.