People with a mild case of COVID-19 who are older than 65 or older than 50 with pre-existing illnesses should use an inhaled asthma drug called budesonide, University of Newcastle Conjoint Professor Josh Davis says.
Budesonide is a "mild steroid, usually used as an asthma prevention medication", said Professor Davis, a John Hunter Hospital infectious diseases expert.
"This has been shown to reduce the risk of deterioration and hospital admission in these higher risk patients."
The pre-existing illnesses include conditions such as diabetes, obesity, kidney disease, congestive heart failure, chronic obstructive pulmonary disease and moderate-to-severe asthma.
Treatments for people with a mild case of COVID, without pre-existing conditions, include paracetamol or ibuprofen for pain or fever.
Those with a moderate case of COVID means "the patient is sick enough to require hospital admission".
This usually means their oxygen levels are mildly decreased and they are having trouble breathing.
"They will be treated with low flow supplemental oxygen (two to three litres a minute through nasal prongs, for example)," Professor Davis said.
At this point, they would be "routinely started on dexamethasone tablets as well as remdesivir intravenously".
Severe disease means that the person's breathing problems and oxygen levels are worsening, despite these treatments.
"If this happens, they will move onto a higher level of breathing support such as high-flow nasal oxygen or non-invasive ventilation via a face mask."
The most severe cases will require "ventilation via a breathing tube inserted into the windpipe, with the patient sedated".
"These patients will be given one of the powerful anti-inflammatory medicines (either baricitinib, tocilizumab or sarilumab) in addition to the other drugs mentioned.
The Newcastle Herald recently reported that eight drugs had been proven to reduce COVID-19-related disease severity and mortality in large randomised controlled trials.
The eight drugs are: dexamethasone and other corticosteroids (anti-inflammatory drugs, given by injection or orally); remdesivir (a repurposed antiviral drug, first developed for Ebola); tocilizumab, sarilumab and baricitnib (powerful anti-inflammatory drugs, used in those with severe lung inflammation); inhaled budesonide (also a corticosteroid, usually used for asthma); and sotrovimab and casirivimab/imdevimab (monoclonal antibodies, given by injection).
The National COVID-19 Clinical Evidence Taskforce, which has a protocol for use of COVID drugs, made a conditional recommendation for the use of sotrovimab [monoclonal antibodies]. This treatment was for use "within five days of symptom onset in adults who do not require oxygen and who have one or more risk factors for disease progression".
It also made this consensus recommendation: "Do not routinely use sotrovimab in fully vaccinated patients unless immunosuppressed".