COVID-19: Treatment recommendations for hospitalised adult patients Clinical Guideline

Version 5.2 approved 27 October 2025

Since the emergence of COVID-19 there have been significant developments in the antiviral and immunomodulatory medications recommended for patients hospitalised with COVID-19.

The COVID-19: Treatment Recommendations for Hospitalised Adult Patients Clinical Guideline (PDF 916KB)  only addresses the use of disease-modifying treatments for COVID-19 in hospitalised adult patients.

This guideline does not:

  • provide guidance of the overall care for patients with COVID-19
  • provide advice regarding supportive therapies recommended for COVID-19
  • provide advice regarding the medication management of mild illness for outpatients
  • provide information regarding the prevention or chemoprophylaxis for the prevention of COVID-19
  • provide advice regarding the treatment and management of COVID-19 in pregnancy and/or breastfeeding.

For information related to the management and care of patients with COVID-19 please refer to:

  • COVID–19 (SARS–COV–2) – Management Guide (CALHN–PRC05409)  on eCentral

Medication recommendations for COVID-19 can change rapidly due to medication shortages, ongoing research and as novel agents are discovered.

Topics covered in this guideline

  1. Definition of COVID-19 disease severity for adults
  2. Risk factors for progressing to severe or critical illness
  3. Classification of immunocompromised patients including medications associated with a reduced immune response to COVID-19 vaccination
  4. COVID-19 treatment recommendations for hospitalised adults according to disease severity (excluding pregnancy/breastfeeding) – mild illness
  5. COVID-19 treatment recommendations for hospitalised adults according to disease severity (excluding pregnancy/breastfeeding) – moderate to critical illness
  6. Assessing a patient for nirmatrelvir plus ritonavir (Paxlovid®) – contraindications and interactions
  7. Approach to treatment of immunocompromised patients with persistent or relapsed COVID-19 infection
  8. Changes to the National Medicines Stockpile (NMS)
  9. Treatments for COVID-19 - Drug Monographs
    1. Remdesivir
    2. Dexamethasone
    3. Molnupiravir
    4. Baricitinib
    5. Nirmatrelvir plus ritonavir
    6. Tocilizumab