Clinical course and management of COVID-19 in the era of widespread population immunity

The clinical implications of COVID-19 have changed since SARS-CoV-2 first emerged in humans. The current high levels of population immunity, due to prior infection and/or vaccination, have been associated with a vastly decreased overall risk of severe disease. Some people, particularly those with im...

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Bibliographic Details
Published in:Nature reviews. Microbiology 2024-02, Vol.22 (2), p.75-88
Main Authors: Meyerowitz, Eric A, Scott, Jake, Richterman, Aaron, Male, Victoria, Cevik, Muge
Format: Article
Language:English
Subjects:
Adult
Antiviral agents
Availability
COVID-19
COVID-19 vaccines
Disease Progression
Female
Herd immunity
Humans
Immunity
Immunity, Herd
Immunomodulation
Immunomodulators
Pandemics
Patients
Pregnancy
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Vaccination
Vaccines
Viral diseases
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Summary:The clinical implications of COVID-19 have changed since SARS-CoV-2 first emerged in humans. The current high levels of population immunity, due to prior infection and/or vaccination, have been associated with a vastly decreased overall risk of severe disease. Some people, particularly those with immunocompromising conditions, remain at risk for severe outcomes. Through the course of the pandemic, variants with somewhat different symptom profiles from the original SARS-CoV-2 virus have emerged. The management of COVID-19 has also changed since 2020, with the increasing availability of evidence-based treatments in two main classes: antivirals and immunomodulators. Selecting the appropriate treatment(s) for patients with COVID-19 requires a deep understanding of the evidence and an awareness of the limitations of applying data that have been largely based on immune-naive populations to patients today who most likely have vaccine-derived and/or infection-derived immunity. In this Review, we provide a summary of the clinical manifestations and approaches to caring for adult patients with COVID-19 in the era of vaccine availability and the dominance of the Omicron subvariants, with a focus on the management of COVID-19 in different patient groups, including immunocompromised, pregnant, vaccinated and unvaccinated patients.
ISSN:1740-1526
1740-1534
DOI:10.1038/s41579-023-01001-1