EsteéoconteúdodoClinicalKey
Inscreva-se hoje para um teste gratuito do ClinicalKey! Seu primeiro passo para obter as respostas certas quando você precisa delas. O ClinicalKey é uma solução de conhecimento clínico projetada para ajudar profissionais de saúde e estudantes a encontrar as respostas certas, fornecendo conhecimento aprofundado e baseado em evidências - tudo em um mesmo recurso.
Nonsevere pneumonia
Overview
Infection control measures: these include isolation, source control, and transmission precautions r51
Supportive care: for all patients; in hospitalized patients, such care includes oxygenation and ventilation, conservative fluid support, and measures to prevent common complications (eg, pressure injury, stress ulceration, secondary infection) r22
Antiviral agents
Monoclonal antibodies with antiviral action (against SARS-CoV-2 spike protein)
Immunomodulators are also being investigated for mitigation of cytokine release syndrome believed to be a factor in severe acute respiratory distress syndrome and shock in COVID-19 (eg, monoclonal antibodies against interleukin-6 receptors, such as tocilizumabr115 and sarilumabr116; Janus kinase inhibitors such as baricitinibr117 and tofacitinibr118)
Systemic corticosteroid therapy is suggested or recommended for most hospitalized patients with an oxygen requirement r22
Antithrombotic therapy
Convalescent plasma continues to be investigated; only high-titer formulations have shown any benefitr133
Several medications with a mechanism of action which could potentially alter response to COVID-19 have been evaluated either for use in treatment and prevention, or for discontinuation to prevent harms r136
Other options not currently recommended under NIH, Infectious Diseases Society of America, and WHO guidelines (although some are still under study in clinical trials) r2r92r93
Product name | Manufacturer | Active ingredient | Age range for use | Comments |
---|---|---|---|---|
Pfizer-BioNTech COVID-19 vaccine (BNT162b2; tozinameran; Comirnaty) | Pfizer-BioNTech | Nucleoside-modified mRNA of SARS-CoV-2 | 6 months or older | • FDA approved in the United States for ages 12 years or older; used under EUA for ages 6 months to 11 years in the United States |
Moderna COVID-19 vaccine (mRNA-1273; Spikevax) | ModernaTX | Synthetic mRNA of SARS-CoV-2 | 6 months or older | • FDA approved in the United States for ages 18 years or older; used under EUA for ages 6 months to 17 years in the United States |
Janssen COVID-19 vaccine | Janssen Biotech, Inc (a Janssen Pharmaceutical Company of Johnson and Johnson) | Recombinant, replication-deficient adenovirus 26 vector expressing SARS-CoV-2 spike glycoprotein (S protein) | 18 years or older | • Investigational; under EUA in the United States • Use in the United States was paused then resumed in April 2021 • On May 5, 2022, FDA limited the use to people aged 18 years or older for whom other approved COVID-19 vaccines are unavailable or not clinically appropriate, or when elected by the recipient who would otherwise not be vaccinated |
Novavax COVID-19 vaccine, adjuvanted | Novavax | Recombinant spike protein (rS) of SARS-CoV-2 | 12 years or older | • Investigational; under EUA in the United States |
Manufacturer | Age | Dose 1 | Dose 2 | Dose 3 | Dose 4 | Notes |
---|---|---|---|---|---|---|
Schedule for individuals who are NOT moderately to severely immunocompromised | ||||||
Pfizer | 6 months to 4 years | Primary monovalent (maroon/maroon), 0.2 mL | In 3 to 8 weeks, primary monovalent (maroon/maroon), 0.2 mL | In at least 8 weeks, primary bivalent (maroon/maroon), 0.2 mL | NA | Maroon formulation requires dilution; no booster doses for children this age who receive 3-dose Pfizer primary series (regardless of whether third dose was monovalent or bivalent) |
Pfizer | 5 years to 11 years | Primary monovalent (orange/orange), 0.2 mL | In 3 to 8 weeks, primary monovalent (orange/orange), 0.2 mL | In at least 2 months, bivalent booster (orange/orange), 0.2 mL | NA | Orange formulation requires dilution; for ages 6 years to 11 years, either Pfizer or Moderna bivalent booster may be used |
Pfizer | 12 years and older | Primary monovalent (gray/gray), 0.3 mL | In 3 to 8 weeks, primary monovalent (gray/gray), 0.3 mL | In at least 2 months, bivalent booster (gray/gray), 0.3 mL | NA | Either Pfizer or Moderna bivalent booster may be used |
Moderna | 6 months to 5 years | Primary monovalent (dark blue/magenta), 0.25 mL | In 4 to 8 weeks, primary monovalent (dark blue/magenta), 0.25 mL | In at least 2 months, bivalent booster (dark pink/yellow), 0.2 mL | NA | Only Moderna bivalent booster is authorized for children aged 6 months to 4 years who receive Moderna primary series; children aged 5 years may receive Moderna or Pfizer booster |
Moderna | 6 years to 11 years | Primary monovalent (dark blue/purple), 0.5 mL | In 4 to 8 weeks, primary monovalent (dark blue/purple), 0.5 mL | In at least 2 months, bivalent booster (dark blue/gray), 0.25 mL | NA | Either Moderna or Pfizer bivalent booster may be used |
Moderna | 12 years and older | Primary monovalent (red/light blue), 0.5 mL | In 4 to 8 weeks, primary monovalent (red/light blue), 0.5 mL | In at least 2 months, bivalent booster (dark blue/gray), 0.5 mL | NA | Either Moderna or Pfizer bivalent booster may be used |
Novavax | 12 years and older | Primary monovalent (royal blue/no color), 0.5 mL | In 3 to 8 weeks, primary monovalent (royal blue/no color), 0.5 mL | NA | NA | In at least 2 months after last primary dose, should receive either Moderna or Pfizer bivalent booster |
Schedule for individuals who ARE moderately to severely immunocompromised | ||||||
Pfizer | 6 months to 4 years | Primary monovalent (maroon/maroon), 0.2 mL | In 3 weeks, primary monovalent (maroon/maroon), 0.2 mL | In at least 8 weeks, primary bivalent (maroon/maroon), 0.2 mL | NA | Maroon formulation requires dilution; no booster doses for children this age who receive 3-dose Pfizer primary series (regardless of whether third dose was monovalent or bivalent) |
Pfizer | 5 years to 11 years | Primary monovalent (orange/orange), 0.2 mL | In 3 weeks, primary monovalent (orange/orange), 0.2 mL | In at least 4 weeks, primary monovalent (orange/orange), 0.2 mL | In at least 2 months, bivalent booster (orange/orange), 0.2 mL | Orange formulation requires dilution; for ages 6 years to 11 years, either Pfizer or Moderna bivalent booster may be used |
Pfizer | 12 years and older | Primary monovalent (gray/gray), 0.3 mL | In 3 to 8 weeks, primary monovalent (gray/gray), 0.3 mL | In at least 4 weeks, primary monovalent (gray/gray), 0.3 mL | In at least 2 months, bivalent booster (gray/gray), 0.3 mL | Either Pfizer or Moderna bivalent booster may be used |
Moderna | 6 months to 5 years | Primary monovalent (dark blue/magenta), 0.25 mL | In 4 weeks, primary monovalent (dark blue/magenta), 0.25 mL | In at least 4 weeks, primary monovalent (dark blue/magenta), 0.25 mL | In at least 2 months, bivalent booster (dark pink/yellow), 0.2 mL | Only Moderna bivalent booster is authorized for children aged 6 months to 4 years who receive Moderna primary series; children aged 5 years may receive Moderna or Pfizer booster |
Moderna | 6 years to 11 years | Primary monovalent (dark blue/purple), 0.5 mL | In 4 weeks, primary monovalent (dark blue/purple), 0.5 mL | In at least 4 weeks, primary monovalent (dark blue/purple), 0.5 mL | In at least 2 months, bivalent booster (dark blue/gray), 0.25 mL | Either Moderna or Pfizer bivalent booster may be used |
Moderna | 12 years and older | Primary monovalent (red/light blue), 0.5 mL | In 4 weeks, primary monovalent (red/light blue), 0.5 mL | In at least 4 weeks, primary monovalent (red/light blue), 0.5 mL | In at least 2 months, bivalent booster (dark blue/gray), 0.5 mL | Either Moderna or Pfizer bivalent booster may be used |
Novavax | 12 years and older | Primary monovalent (royal blue/no color), 0.5 mL | In 3 to 8 weeks, primary monovalent (royal blue/no color), 0.5 mL | NA | NA | In at least 2 months after last primary dose, should receive either Moderna or Pfizer bivalent booster |