Use of two recombinant human monoclonal antibodies that bind to the SARS-CoV-2 spike protein, casirivimab and imdevimab, is conditionally recommended for patients with non severe disease at highest risk for severe disease and for severe and critical infection among seronegative patients, according to a living guideline published in The BMJ. Researchers who developed the guideline update based on preprints of four randomized trials among patients with non-severe illness and a trial among severe and critically ill patients with COVID-19 conditionally recommend that the combination of casirivimab and imdevimab be used for patients with non-severe disease at highest risk for severe disease. The evidence demonstrated a likely reduction in the need for hospitalization, with greater absolute benefit for those at highest risk for hospitalization. Pooled data indicated trivial or no effects on mortality or need for mechanical ventilation due to very low risk at baseline. For patients with severe and critical infection, casirivimab-imdevimab is conditionally recommended if the individual has seronegative status.