Outpatient Evaluation and Management of COVID-19

The rapid rise of the Omicron SARS-CoV-2 variant ushered in year 3 of the COVID-19 pandemic. Omicron changed the nature of the pandemic in many ways. While transmission is rampant, resulting illness, particularly in vaccinated persons, is generally less severe than with prior variants. While the Omicron surge stressed health care systems in many locations, the situation has tended to be less dire in most areas of the United States than earlier in the pandemic when critical care resources were in short supply and morgues were overflowing. Further, just as Omicron emerged, so did effective outpatient therapies to prevent severe illness and death if administered to high-risk persons soon after COVID-19 diagnosis. These therapies promise to further change the nature of the pandemic.

With these developments came many questions about the outpatient evaluation and management of COVID-19. Are the appropriate actions following an exposure different for vaccinated and unvaccinated persons? What is the best way to use COVID-19 tests for diagnosis and to gauge infectiousness? Who is eligible for each of the newly available therapies, and when will availability be widespread? For persons currently ineligible for or without access to newly approved therapies, should unapproved uses of readily available drugs and supplements be considered? To seek practical answers to these questions based on current knowledge, the Annals of Internal Medicine and the American College of Physicians held their eighth COVID-19 forum on 9 February 2022. The topic of this program was outpatient evaluation and management of COVID-19.