How to treat mild, moderate, and severe COVID-19 symptoms

Did you test positive for COVID-19? Your first step is to let your doctor know. If you have a mild or moderate case, there’s a good chance you’ll be able to rest and recover at home. And if you get really sick? Doctors have a lot of effective medicines and treatments in their tool kit.

Some treatments are approved by the U.S. Food and Drug Administration (FDA). Others are available only through emergency use authorization (EUA). This means the FDA approved them for use during the pandemic without all the evidence it might typically require. There was still enough data to show the treatments are effective and safe.

Any treatments should be prescribed or approved by your doctor. That’s why it’s so important to stay in touch with your medical provider through all stages of your illness, even if it seems mild.

Read on to learn how experts define mild, moderate, and severe COVID-19. We’ve got details on the different treatments for each stage of the disease too.

What is mild COVID-19 illness?

About 80% of people with COVID-19 have mild or moderate illness. This generally means they can rest at home until they get better. Symptoms start anywhere from two days to two weeks after exposure. So what are the symptoms of COVID-19? They can include:

• Fever
• Cough
• Fatigue
• Congestion or runny nose
• Chills
• Muscle aches
• Headache
• Sore throat
• Loss of taste or smell
• Diarrhea
• Nausea or vomiting

Your treatment options

Talk to your doctor about which treatments are right for you. Your provider might recommend one or more of the following:

Over-the-counter (OTC) pain relievers like acetaminophen or ibuprofen. They can ease fever and body aches. While there were some early concerns that ibuprofen could worsen COVID-19, research shows that’s not the case. Ask your doctor which pain reliever is the best choice for you.

OTC cough medications. Look for one that contains the cough suppressant dextromethorphan if your cough is uncomfortable or makes it hard to sleep.

Monoclonal antibodies. Antibodies are proteins that your body makes to fight off disease while you’re sick. Monoclonal antibodies are produced in a lab. They are delivered through shots or an IV at a doctor’s office or infusion center. You must get them within the first seven days of symptoms.

The FDA allows this treatment for people age 12 and older who are at high risk for complications from the virus. You may be eligible if you:

• Have a body mass index (BMI) of 30 or higher
• Have chronic kidney disease
• Have diabetes
• Have a disease that compromises your immune system like HIV, cancer or rheumatoid arthritis
• Are 65 or older
• Are unvaccinated
• Have a lung condition like chronic obstructive pulmonary disease (COPD) or a heart condition like heart failure

Antiviral medications. These medications work by preventing the virus from multiplying. They can help you avoid more dangerous symptoms. They may also keep you from ending up in the hospital if you’re at risk of getting severe COVID-19.

• Oral antiviral medications are prescription pills you can take at home. There are a few options: Paxlovid is for people 12 years old and up. Lagevrio is for people 18 and older. These medications need to be taken within five days of the start of symptoms. That’s why it’s key to call your doctor as soon as you feel sick.
• IV antiviral medication (remdesivir) is given via an infusion at a medical center. Remdesivir is approved by the FDA to treat COVID-19 in high-risk adults and children. You have to begin treatment within seven days of the start of your symptoms.

What is moderate COVID-19 illness?

Some people who begin with mild symptoms of COVID-19 find that they get worse. This is more likely to happen if you have risk factors for severe disease. Common risk factors include obesity and type 2 diabetes. In addition to all the symptoms of mild COVID-19, the main symptom of moderate illness is respiratory issues like shortness of breath.

Your treatment options

If you have trouble breathing, let your doctor know right away. They may send you for a chest X-ray to rule out pneumonia. They may also have you watch your blood oxygen level at home with a pulse oximeter, a small device you place on your finger.

The treatment options are the same as if you have mild symptoms. But if your oxygen level dips below 94%, you may need to go to the hospital.

What is severe COVID-19 illness?

About 14% of people with COVID-19 develop disease severe enough to need care in the hospital. Often this is due to pneumonia or hypoxemia, a condition in which your blood levels of oxygen are lower than they should be. The CDC recommends that you go to the hospital for emergency medical attention if you have these symptoms:

• Trouble breathing
• Persistent pain or pressure in your chest
• New confusion
• Inability to wake up or stay awake
• Bluish skin, fingernails, and lips

You may need to stay in the intensive care unit to get critical care.

Your treatment options

Oxygen. Most people who need to stay in the hospital with COVID-19 require extra oxygen to help them breathe.

Steroids. These may reduce some of the inflammation caused by COVID-19. Steroids have been shown to help hospitalized patients who need supplemental oxygen. If you are on supplemental oxygen, steroids may reduce your risk of death. In some cases, monoclonal antibodies may be used with steroid treatment.

Medications. The antiviral medication remdesivir is also given, via IV, in the hospital. It may shorten your time in the hospital. You are more likely to get it if you need minimal or no supplemental oxygen. In severe cases, such as when oxygen is needed, the oral medication baricitinib is given. It’s FDA-approved for adults and kids as young as age 2.

Blood thinners. COVID-19 can also damage other organs like your heart or brain. Blood thinners can help prevent or treat blood clots.

Convalescent plasma. Plasma from patients who have recovered from COVID-19 can contain antibodies to the virus. Giving this plasma as a transfusion may help the immune system recognize and respond better to the virus. But this treatment is rarely used today. It is only currently authorized by the FDA for people who have compromised immune systems.

Prevention is the best strategy for keeping you well

It’s important to get the COVID-19 vaccine. Everyone 6 months and older should get the primary series, says the CDC. People ages 5 and up should also get one updated (bivalent) booster shot.

Getting vaccinated serves a few purposes. First, it helps reduce your chances of getting severe COVID-19. It can also cut your risk of developing long COVID. With this condition, symptoms can linger months or longer after the initial infection has gone away.

People who cannot get vaccinated for medical reasons may be eligible for Evusheld. This is a long-acting antibody treatment. You get two initial shots, then doses every six months after that.

There are other ways to help prevent COVID-19:

• Wash your hands with soap and water often. If you’re not near a sink, use a hand-sanitizing gel that has at least 60% alcohol.
• Stick with outdoor events, if you can, and limit time spent in large crowds.
• Test yourself at home with rapid antigen tests if you have symptoms or have been exposed.
• Wear a face mask at public indoor spaces if there is high spread in your community.

The information in this story is accurate as of press time and posting. Staying up to date with your COVID-19 vaccines is one of the best ways to limit the spread of the coronavirus. This includes getting booster shots such as the new bivalent booster when applicable. It’s also important to wear a mask indoors in public when the infection level is high in your area. According to the CDC’s latest guidance, respirator masks (like an N95 mask) provide the most protection. If you are at high risk of getting sick, keep your distance from others and avoid crowded places. Because the situation surrounding COVID-19 continues to evolve, we encourage readers to follow the news and recommendations for their own communities by using the resources from the CDC, WHO, their local public health department, and our COVID-19 member site.