COVID-19 Treatment Information

Treatment options for COVID-19

As of May 2022, several treatment options are available under Emergency Use Authorization (EUA) for COVID-19.

  • Options for patients not requiring hospitalization or supplemental oxygen include Paxlovid, Molnupiravir and Remdesivir.

 

Vulnerable populations at risk for severe COVID-19

Certain populations are at greater risk of progressing to severe disease and warrant more significant consideration for prophylaxis or treatment. This includes patients who are older (≥65 years), have comorbidities, or are immunocompromised.

When necessary, providers should prioritize treating patients at high risk for progression to severe COVID-19 illness, including older and immunocompromised individuals and those with clinical risk factors.





Pre-exposure treatments

Evusheld consists of co-packaged monoclonal antibodies (tixagevimab and cilgavimab) authorized for pre-exposure prophylaxis of COVID-19. Administering Evusheld as soon as possible may help protect patients who remain at risk despite the availability of COVID-19 vaccines.

Evusheld is authorized in adults and pediatric individuals (≥12 years, ≥40 kg):

  • who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual infected with SARS-CoV-2,
  • who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments,
  • who may not mount an adequate immune response to COVID-19 vaccination, and/or
  • for whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine and/or COVID-19 vaccine component

 

Evusheld is not authorized:

  • for treatment of COVID-19 or
  • for post-exposure prophylaxis of COVID-19

Common adverse events include headache, fatigue and cough.



Post-exposure treatments

Paxlovid is an oral treatment that must be initiated as soon as possible after COVID-19 diagnosis, within five days of symptom onset.

 

Paxlovid is authorized for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (≥12 years of age, ≥40 kg):

  • with positive results of direct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing and
  • who are at high risk for progression to severe COVID-19, including hospitalization or death

 

Paxlovid is not authorized:

  • in patients requiring hospitalization due to severe or critical COVID-19,
  • for pre-exposure or post-exposure prophylaxis for prevention of COVID-19, or
  • for use longer than five consecutive days

 

Common adverse events include dysgeusia, diarrhea, hypertension and myalgia.

Molnupiravir is an oral antiviral treatment that must be initiated as soon as possible after COVID-19 diagnosis, within five days of symptom onset.

 

Molnupiravir is authorized in adults:

  • with positive results of direct SARS-CoV-2 viral testing,
  • who are at high risk for progression to severe COVID-19, including hospitalization or death, and
  • for whom alternative COVID-19 treatment options are not accessible or clinically appropriate

 

Molnupiravir is not authorized:

  • in pediatric patients (≤18 years),
  • for initiation of treatment in patients hospitalized with COVID-19,
  • for use longer than five consecutive days, or
  • for pre-exposure or post-exposure prophylaxis for the prevention of COVID-19

 

Common adverse events with Molnupiravir include diarrhea, nausea and dizziness.

On November 30, 2022, the U.S. Food and Drug Administration (FDA) revised the Emergency Use Authorization (EUA) to discontinue the administration of Bebtelovimab. Click here to read the full FDA announcement.

Remdesivir, under the trade name VEKLURY, is an out-patient early treatment option for patients diagnosed with mild-to-moderate COVID-19 and are at a high risk of severe disease. Remdesivir should be initiated within seven days of symptom onset.

 

  • Remdesivir is approved for the treatment of non-hospitalized adults and pediatric patients (≥12 years old, ≥40 kg).
  • The FDA expanded the approval for the treatment of pediatric patients who are older than 28 days, weighing at least 3 kg, and are either hospitalized with COVID-19 or have mild-to-moderate COVID-19 and are considered high risk for progression to severe COVID-19, including hospitalization or death.

 

Common adverse reactions include nausea, ALT increase and AST increase.



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