Coronavirus Disease 2019 (COVID-19): Treatment
Your health care provider will decide on what approach to take for your treatment. There are drugs that have shown some benefit in reducing the severity of illness or risk of death for patients in the hospital by:
Slowing the Virus
Antiviral medications reduce the ability of the virus to multiply and spread through the body.
- Remdesivir (Veklury) is an antiviral medication approved by FDA to treat COVID-19. The current NIH COVID-19 Treatment Guidelines recommend remdesivir for hospitalized adult and pediatric patients (12 years of age and older and weighing at least 88 pounds). Remdesivir is given by daily intravenous infusions for five days in most patients or 10 days among those on ventilators or life support.
Oral Medications for COVID-19 Made Available Under Emergency Use Authorization for Non-Hospitalized Patients
Paxlovid (nirmatrelvir co-packaged with ritonavir) is an oral medication therapy consisting of two 150mg capsules of nirmatrelvir and one 100 mg capsule of ritonavir (3 pills total) taken twice a day for 5 days to treat COVID-19 in those above the age of 12 years or 40 kg who are at high risk of progressing to severe disease. Therapy must be started within 5 days of developing COVID-19 symptoms. Illinois will receive 2040 courses of Paxlovid in the first release from HHS. We anticipate receiving allocations from HHS on a two-week cycle schedule. Requests for Paxlovid on the Health Partner Ordering Portal (HPOP) opened on 12/22 with shipping to begin the week of 12/27.
Molnupiravir is an oral antiviral now authorized for the treatment of mild to moderate COVID-19 in adults age 18 years and older, who are at high risk for progressing to severe COVID-19 and for whom alternative COVID-19 treatment options are not accessible or clinically appropriate. It is administered as four 200 mg capsules taken orally every 12 hours for five days, for a total of 40 capsules. Therapy must be started within 5 days of developing symptoms. Molnupiravir is not authorized for use in those under the age of 18 years, or for pregnant or lactating women due to the possibility of fetal harm. Illinois has been allocated 9540 courses of molnupiravir this cycle. Requests for Molnupiravir on HPOP begins on 12/23 with shipping to begin on 12/29.
For People at High Risk of Disease Progression
The U.S. Food and Drug Administration (FDA) has issued emergency use authorization (EUA) for two investigational monoclonal antibodies, which are laboratory-made proteins that mimic the immune system’s ability to fight off harmful viruses and bacteria that can cause disease. These antibodies (bamlanivimab and a combination of casirivimab/imdevimab) could help the immune system recognize and respond more effectively to the virus in non-hospitalized adult and pediatric patients with mild-to-moderate COVID-19 who are at high risk for progressing to severe disease and/or hospitalization.
Preliminary data suggest that some outpatients may benefit from receiving anti-SARS-CoV-2 monoclonal antibodies early in the course of infection. The NIH COVID-19 Treatment Guidelines find that, to date, there are insufficient data from clinical trials to recommend for or against these treatments and these treatments should not be considered standard of care.
Reducing an Overactive Immune Response
In patients with severe COVID-19, the body’s immune system may overreact to the threat of the virus, worsening the disease. This can cause damage to the body’s organs and tissues. Some treatments can help reduce this overactive immune response.
- Dexamethasone is a steroid medication, similar to a natural hormone produced by the body. The NIH COVID-19 Treatment Guidelines recommend dexamethasone, or a similar medication, to prevent or reduce injury to the body for some hospitalized patients with severe COVID-19. Dexamethasone is recommended for patients who need supplemental oxygen.
COVID-19 can damage the heart, blood vessels, kidneys, brain, skin, eyes, and gastrointestinal organs. It also can cause other complications. Depending on the complications, additional treatments might be used for severely ill hospitalized patients, such as blood thinners to prevent or treat blood clots.
Supporting the Body’s Immune Function
Plasma from patients who have recovered from COVID-19—called convalescent plasma—can contain antibodies to the virus. This could help the immune system recognize and respond more effectively to the virus, but currently the NIH COVID-19 Treatment Guidelines find there is not enough evidence to recommend these treatments.