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Treating Mild Cases of COVID-19 at Home

Most people who develop a COVID-19 infection, especially those who are younger and healthier, will have a mild case and will not need to go to the hospital for treatment. If you or someone at home have a COVID-19 infection that is mild, you still may have symptoms that make you feel poorly. The most commonly reported symptoms of COVID-19 include fever, dry cough, shortness of breath, tiredness, chills, repeated shaking with chills, muscle pain, headache, sore throat, and sudden loss of taste or smell. This article contains information on how you can manage the symptoms caused by a mild case of COVID-19 at home.

Important actions
There are two very important roles everyone must perform at home when someone is sick. The first role is to monitor your loved one for worsening symptoms and keep an eye out for the emergency warning signs listed below. Call your healthcare provider if you have concerns about any symptoms. If symptoms need immediate attention, call 911 and notify the operator that you have COVID-19 concerns. Emergency warning signs include the following:

  • Trouble breathing
  • Shortness of breath - where you cannot catch your breath doing an activity you normally can such as walking across the room or going up the stairs
  • Persistent pain or pressure in the chest
  • Confusion or inability to arouse
  • Bluish lips or face

If you or a loved one experience or are concerned about any symptoms, even those that are not listed above, call your healthcare provider.

The second important role for you and members of your household is to prevent the spread of COVID-19 to others in the house and your community. This includes:

  • Have the sick person stay in one room and use a separate bathroom
  • Avoid sharing personal household items
  • Ask the sick person to wear a facemask around people
  • Wash your hands often with soap and water for at least 20 seconds or use a hand sanitizer that contains at least 60% alcohol
  • Avoid touching your eyes, nose, and mouth
  • Disinfect surfaces that are touched often

How can I treat COVID-19 symptoms at home?
At this time, there are no medicines that are known to effectively treat the COVID-19 infection. However, there are things you can do to feel better. Getting plenty of rest, drinking fluids, and over-the-counter (OTC) medicines can be used to manage mild symptoms. However, if you or a loved one is experiencing any of the emergency warning signs listed above, call 911 for immediate medical attention.

Here’s a list of the most common symptoms associated with a mild COVID-19 infection and suggested therapies to manage those symptoms:

Fever and body aches
A fever occurs when your body acts to fight the infection. A fever often makes you feel tired and uncomfortable. COVID-19 also commonly causes body and muscle aches. Drink plenty of fluids to manage fevers and aches. With high temperatures, your body loses fluid through sweating, so stay hydrated to replace fluid loss.

OTC medicines can lower your fever and improve discomfort. Acetaminophen (Tylenol) is the preferred medication. The adult dose of acetaminophen is 650 mg every 4 to 6 hours. The total daily dose should not exceed 3250 mg in 24 hours because higher amounts may damage your liver. Many OTC combination products also contain acetaminophen. Do not use additional acetaminophen for fever and body aches if you are using a combination product with acetaminophen. Acetaminophen is given to children in a liquid form based on their weight. Be sure to measure liquid products with an oral syringe, not a household teaspoon, and read the medication’s label to determine the correct dose.

Non-steroidal anti-inflammatory medications (NSAIDs) are a second option. These OTC medications will help with pain and discomfort, lower your fever, and reduce inflammation. Ibuprofen (Advil, Motrin) and Naproxen (Aleve) are examples of NSAIDs. Always read the product label carefully as these products have risks when used in certain people. Avoid NSAIDs in people with stomach ulcers or stomach-related bleeding or that take a blood-thinning or steroid drug to reduce the risk of stomach bleeding. These medications may also negatively affect how kidneys work, and older adults are more likely to experience these complications.

Dry cough and sore throat
A cough is the body’s way of removing irritants that enter the lung, such as the COVID-19 virus. Drinking plenty of fluids, sipping on hot broth or tea, taking a teaspoon of honey, or sucking on hard candy or cough drops may help soothe irritation in your throat. Using a sore throat spray that contains phenol also may reduce pain and irritation. A humidifier can add moisture to the air, which may ease coughing.

Studies of OTC cough suppressants have shown mixed results when used to control a cough. Some studies suggest that cough products with dextromethorphan may help reduce the severity of a dry cough. Dextromethorphan products are not recommended in children under 4 years of age.

Tiredness
As your body fights the infection, you will feel tired. The treatment is simply rest.

Sudden loss of taste or smell
There are reports of patients with the COVID-19 infection experiencing a sudden loss of taste or smell. These symptoms may appear early in the disease before other symptoms. There are no recommended treatments for these symptoms.

Nasal congestion
Although nasal congestion may occur, it has not been a common symptom associated with COVID-19. OTC cough and cold medications may be used to treat nasal congestion.

Decongestants with or without antihistamines are effective in helping reduce nasal congestion and are available primarily as combination products. Decongestants such as pseudoephedrine (Sudafed), which can only be purchased behind the counter in the pharmacy, and phenylephrine (Sudafed PE) decrease the fluid in the nasal passages and allow for easier breathing. Antihistamines dry up mucous membranes of the nose and other areas such as mouth and eyes. Nasal decongestant sprays, such as oxymetazoline (Afrin, Vick’s Sinex) and phenylephrine (Neo-Synephrine), can also be helpful.

It should be noted that decongestants interact with many medical conditions such as diabetes, hypertension, and glaucoma, and interacts with many medications. Antihistamines interact with many medical conditions and medications, as well. Antihistamines cause sleepiness, and confusion and other problems in the elderly. Check with your pharmacist or doctor to get specific guidance about using decongestants or antihistamines. Women who are pregnant should also talk to their healthcare provider before using a decongestant or antihistamine.

What if the medications I have in my medicine cabinet have expired?
The expiration date on the package is the date up to which the manufacturer guarantees potency and safety of the medication. The date is arbitrary in that it reflects how long the medication was tested for potency and safety by the manufacturer.

Many medications remain potent and safe beyond the expiration date, including the OTC medications listed above. If you have expired medication that looks intact, has no discoloration or disintegration, and has been stored as recommended, then it is likely okay to take.

However, not all medications remain safe and potent past their expiration date. Some medications are unsafe or no longer potent. These include insulin, nitroglycerin, tetracyclines, refrigerated medications, eye drops, and a drug class called biologics.

Summary
A readily available resource to help you understand your medications is the pharmacist at your local pharmacy. If your pharmacist knows you and the medicines you are taking, then they are likely the best resource to help you choose the right OTC therapies. Many pharmacies will deliver medicines during this pandemic. Ask if this is possible for any of the medications you may need to purchase.

In addition, it is important to carefully read the drug facts label for each medication, including OTC medications, to identify the ingredients in the product. This is especially important when purchasing combination cough and cold medications to avoid accidentally taking too much of a medication. Talk to your pharmacist or another healthcare provider if you have any questions about your medications.

Mary Ann Kliethermes, Pharm.D., Director of Medication Safety and Quality at ASHP