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FOR APPROPRIATE COVID-19 PATIENTS AT HIGH RISK FOR PROGRESSION TO SEVERE ILLNESS,

INITIATE ORAL TREATMENT
WITHIN 5 DAYS OF SYMPTOM ONSET

Developed by Pfizer Inc.

Section components

The progression of COVID-191,2

Early in the course of disease, patients may experience mild symptoms as SARS-CoV-2 replicates. In many patients, the immune system responds and prevents the virus from spreading. But in patients who develop severe illness, an abnormal immune response occurs, leading to respiratory and even systemic inflammation.

Early Infection2,3

Pulmonary Response2,3

Hyperinflammation2,3

Disease severity

Early Infection2,3

Median 4-5 days

Mild symptoms, fever, dry cough, anosmia, dysgeusia

Pulmonary Response2,3

Median 5-8 days

Shortness of breath, with or without hypoxia

Hyperinflammation2,3

Median 8-12 days

Systemic inflammatory response syndrome, cytokine storm, acute respiratory distress syndrome, shock, cardiac failure

Viral
replication
Mild to
moderate
illness
Severe
illness
Critical
illness
Section Image
high-risk COVID-19 patient

Educate your high-risk patients before they get COVID-19 so they understand their:4,5,6-8

R
I
S
K

Click to explore

Risk

for severe illness

Importance

of testing quickly if they experience symptoms

Source

of testing and care

Knowing

if they are appropriate candidates for authorized or approved treatment options

Section components

Footnotes

Summary of conditions with evidence based on what has been reported in the literature at the time of CDC review. Definitions for each group of medical conditions with evidence can be found at https://www.cdc.gov/​coronavirus/​2019-ncov/​hcp/clinical-care/​underlyingconditions.html

Complete list of disabilities from CDC's systematic review process can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html

BMI=body mass index; COPD=chronic obstructive pulmonary disease; HIV=human immunodeficiency virus.

References

References: 1. Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ. 2020;371:m3862. 2. Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant. 2020;39(5):405-407. 3. Management of patients. Centers for Disease Control and Prevention. Published June 30, 2020. Accessed April 18, 2022. https://stacks.cdc.gov/view/cdc/89980 4. Coronavirus (COVID-19) update: FDA authorizes first oral antiviral for treatment of COVID-19. U.S. Food and Drug Administration. Published December 22, 2021. Accessed April 21, 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-covid-19 5. Coronavirus (COVID-19) update: FDA authorizes additional oral antiviral for treatment of COVID-19 in certain adults. U.S. Food and Drug Administration. Published December 23, 2021. Accessed April 21, 2022. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-treatment-covid-19-certain 6. Ajufo E, Rao S, Navar AM, Pandey A, Ayers CR, Khera A. U.S. population at increased risk of severe illness from COVID-19. Am J Prev Cardiol. 2021;6(100156):100156.7. COVID-19 information for specific groups of people. Centers for Disease Control and Prevention. Published June 3, 2022. Accessed June 8, 2022. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html#:~:text=If%20you%20or%20 your%20family,high%20COVID%2D19%20 Community%20Level 8. Test for current infection. Centers for Disease Control and Prevention. Published June 1, 2022. Accessed June 8, 2022. https://www.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html

Help patients recognize if they're at high risk for progression to severe COVID-193†

Three important factors to consider are
Age, Race & Ethnicity, and Vaccination Status

Studies have shown that COVID-19 does not affect all populations equally. Age is the strongest risk factor for progressing to severe COVID-19. Additionally, the COVID-19 pandemic has highlighted racial, ethnic, and socioeconomic disparities in COVID-19 illnesses, hospitalizations, and deaths. This is due to multiple factors, including barriers to accessing health care.

View Risk Factors

Looking for a comprehensive list of COVID-19 symptoms?

Footnotes

Summary of conditions with evidence based on what has been reported in the literature at the time of CDC review. Definitions for each group of medical conditions with evidence can be found at https://www.cdc.gov/​coronavirus/​2019-ncov/​hcp/clinical-care/​underlyingconditions.html

Complete list of disabilities from CDC's systematic review process can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html

BMI=body mass index; COPD=chronic obstructive pulmonary disease; HIV=human immunodeficiency virus.

Underlying medical conditions associated
with higher risk for severe COVID-193

Close
Higher Risk
Suggestive Higher Risk
Mixed Evidence

Asthma

Cancer

Cerebrovascular disease

Chronic kidney disease

Chronic liver diseases limited to:
- Cirrhosis
- Nonalcoholic fatty liver disease
- Alcoholic liver disease
- Autoimmune hepatitis

Chronic lung diseases limited to:
- Interstitial lung disease
- Pulmonary embolism
- Pulmonary hypertension
- Bronchiectasis
- COPD

Cystic fibrosis

Diabetes mellitus, type 1 and type 2

Disabilities, including Down syndrome

Heart conditions
(such as heart failure, coronary artery disease, or cardiomyopathies)

HIV

Mental health conditions limited to:
- Mood disorders, including depression
- Schizophrenia spectrum disorders

Neurologic conditions limited to dementia

Obesity
(BMI ≥30 kg/m2 or ≥95th
percentile in children)

Physical inactivity

Pregnancy and recent pregnancy

Primary immunodeficiencies

Smoking, current and former

Solid organ or blood stem cell transplantation

Tuberculosis

Use of corticosteroids or other immunosuppressive medications

Asthma

Cancer

Cerebrovascular disease

Chronic kidney disease

Chronic liver diseases limited to:
- Cirrhosis
- Nonalcoholic fatty liver disease
- Alcoholic liver disease
- Autoimmune hepatitis

Chronic lung diseases limited to:
- Interstitial lung disease
- Pulmonary embolism
- Pulmonary hypertension
- Bronchiectasis
- COPD

Cystic fibrosis

Diabetes mellitus, type 1 and type 2

Disabilities, including Down syndrome

Heart conditions
(such as heart failure, coronary artery disease, or cardiomyopathies)

HIV

Mental health conditions limited to:
- Mood disorders, including depression
- Schizophrenia spectrum disorders

Neurologic conditions limited to dementia

Obesity
(BMI ≥30 kg/m2 or ≥95th percentile in children)

Physical inactivity

Pregnancy and recent pregnancy

Primary immunodeficiencies

Smoking, current and former

Solid organ or blood stem cell transplantation

Tuberculosis

Use of corticosteroids or other immunosuppressive medications

Children with certain underlying conditions

Overweight (BMI ≥25 kg/m2 but ≤30 kg/m2 )

Sickle cell disease

Substance use disorders

Alpha-1 antitrypsin deficiency

Bronchopulmonary dysplasia

Hepatitis B and C

Hypertension

Thalassemia

No conclusions can be drawn from the evidence.