Treatment Options for COVID-19 Infection

Treatment is available for those at increased risk for severe infection. Starting these treatments quickly after you begin to experience symptoms can help you avoid becoming extremely ill or even hospitalized. The oral medication, Paxlovid (Nirmatrelvir/Ritonavir), is the first line therapy. An alternative oral medication called Legevrio (Molnupiravir) is also available but less effective. Lastly, an outpatient infusion therapy with a medication called Veklury (Remdesivir) is appropriate for a small number of high-risk patients who do not qualify for the oral medications. Monoclonal antibodies are not effective against the new variants and are no longer offered.

Paxlovid

The first line of defense is a medication called Paxlovid, which is available under Emergency Use Authorization by the FDA. You may be eligible to be treated with Paxlovid if you have mild to moderate symptoms of COVID-19, you’ve tested positive for COVID-19, are age 12 or older and weigh at least 88 pounds, and have one of the following conditions:

• Chronic lung disease
• Diabetic
• Cardiovascular disease
• On dialysis
• Overweight (BMI greater than 25)
• Immunocompromised, including the following conditions:
  • Primary immunodeficiency
  • Active chemotherapy
  • Transplant
  • Biologic immunomodulators/immunosuppressive drugs
  • HIV with uncontrolled viral load
  • Taking high dose steroids 20 mg/day at least two weeks)
  • Pregnant

Other facts you need to know

• Paxlovid must be started within five days of the onset of symptoms.
• There are multiple drug interactions. These interactions are listed in the EUA and should be discussed with your provider.
• Data shows that Paxlovid decreased risk of hospitalization and death by 88% if started within 5 days of onset of symptoms.
• Side effects include an unpleasant taste, GI symptoms and a 5-6% chance of mild rebound infection (3-5 days after stopping).

Veklury

Veklury is given by IV infusion for 3 consecutive days. You may be eligible for Veklury it you have tested positive for COVID, have mild to moderate COVID symptoms and meet all of the following:

• Cannot take Paxlovid
• Age 12 or older (minimum 88 pounds)
• No active liver inflammation disease AND
• Have at least 1 of these conditions:
  
  • Moderate or severe immunocompromise
  • Age 75 or older
  • Age 65 or older and require oxygen for COPD or have end stage kidney disease
  • Pregnancy

Veklury is covered by Medicare and most insurances. Like Paxlovid, Veklury treatment decreases the risk of hospitalization or death by nearly 89%.

Talk with your doctor to see if treatment is right for you

If you have a Henry Ford doctor, please ask your doctor to submit an Epic order for Paxlovid or to be assessed for Veklury infusions (all physicians can use the Referring Physician Office to place orders).