What are some key counseling points to include when prescribing treatment for COVID-19?

▪ For those who are eligible, discuss the benefits, efficacy, and goals of treatment, along with standard counseling on common and rare side effects when prescribing any medication.

▪ For those who are NOT eligible, explain why they do not qualify for a prescription. Some patients may feel confused or upset if they cannot have the treatment for COVID-19. Reassure them that the health care team is providing the best, evidence-based treatment and care even if it cannot include oral antivirals. Any member of the health care team taking care of low-risk patients who are not eligible for oral antivirals can explain that oral antivirals are only indicated for people at risk for developing complications that may lead to death. Oral antivirals have not been shown to reduce illness severity in low-risk patients, and benefit has not been demonstrated in people at-risk who start treatment more than five days after symptom onset. Supportive symptom management at home will likely have the same therapeutic effect without the concerns for side effects of the medication.

▪ Counsel patients to remain in isolation through the course of treatment (5 days after diagnosis); After day 5, continue isolation if still having significant symptoms or requiring medication for fever and symptom control.

▪ Counsel patients about basic supportive care (i.e., rest, hydration, nutrition, analgesia, antipyretics, etc.) and about the typical progression of mild or moderate COVID-19.

▪ Tell patients if their symptoms worsen to contact a health care provider or return to the clinic for further evaluation.

▪ Counsel patients to contact the health care team if rebound symptoms occur. Rebound symptoms have been reported but are usually mild. If COVID-19 symptoms return after completion of the oral antiviral course, consider repeat testing and have the patient continue to isolate if still testing positive for COVID-19. A repeat course of oral antivirals is not indicated for rebound symptoms.

▪ If patients live with other people, consider potential exposure to those individuals and their possible risk factors. Encourage patients and families to remain vigilant and test liberally

-By EPiC FHI360