From the Guidelines
The current treatment for COVID-19 should prioritize the use of antiviral medications such as Paxlovid (nirmatrelvir/ritonavir) or Lagevrio (molnupiravir) for higher-risk individuals with mild to moderate COVID-19 within 5 days of symptom onset, as recommended by the most recent guidelines 1.
Treatment Overview
The treatment approach for COVID-19 varies based on the severity of symptoms and individual risk factors. For mild cases, supportive care including rest, hydration, and over-the-counter medications like acetaminophen or ibuprofen can help manage symptoms.
Antiviral Medications
For higher-risk individuals with mild to moderate COVID-19, antiviral medications such as Paxlovid (nirmatrelvir/ritonavir) or Lagevrio (molnupiravir) are recommended within 5 days of symptom onset 1. Paxlovid is typically given as 300mg nirmatrelvir with 100mg ritonavir twice daily for 5 days.
Severe Cases
For severe cases requiring hospitalization, treatments may include remdesivir, dexamethasone, and oxygen therapy. The use of corticosteroids, particularly dexamethasone, has been supported by evidence to decrease mortality in hospitalized patients with COVID-19 1.
Immunomodulatory Therapies
The use of immunomodulatory therapies such as tocilizumab, baricitinib, or tofacitinib may be considered in specific cases, particularly for patients requiring supplemental oxygen, non-invasive or mechanical ventilation, as they may reduce disease progression and mortality 1.
Monoclonal Antibody Treatments
Monoclonal antibody treatments are less commonly used now due to viral mutations affecting their efficacy, but may still be considered for patients at risk of severe COVID-19 course, with symptom onset <5 days, or still seronegative 1.
Individualized Treatment Decisions
Treatment decisions should be individualized based on age, vaccination status, underlying conditions, and disease severity. Early treatment is crucial for the best outcomes, so testing promptly after symptom onset is important.
From the FDA Drug Label
VEKLURY is indicated for the treatment of coronavirus disease 2019 (COVID-19) in adults and pediatric patients (birth to less than 18 years of age weighing at least 1.5 kg) who are [see Clinical Studies (14)]: Hospitalized, or Not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19, including hospitalization or death.
The current treatment for Coronavirus disease (COVID-19) is remdesivir (IV), also known as VEKLURY.
- Hospitalized patients: The recommended total treatment duration is 10 days for those requiring invasive mechanical ventilation and/or ECMO, and 5 days for those not requiring invasive mechanical ventilation and/or ECMO.
- Non-hospitalized patients: The recommended total treatment duration is 3 days for those diagnosed with mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19. 2 2 2
From the Research
Current Treatments for COVID-19
The current treatments for Coronavirus disease (COVID-19) include:
- Antiviral agents such as remdesivir, molnupiravir, and nirmatrelvir/ritonavir 3, 4, 5, 6
- Corticosteroids, such as dexamethasone, for hospitalized patients with severe or critical COVID-19 3, 4
- Tocilizumab, an interleukin-6 receptor antagonist, for use in combination with a corticosteroid in certain hospitalized patients 3, 4
- Monoclonal antibody combinations, such as bamlanivimab/etesevimab and casirivimab/imdevimab, for non-hospitalized patients with mild-to-moderate COVID-19 at high risk of disease progression 3, 4
Treatment Recommendations
Treatment recommendations for COVID-19 vary depending on disease severity:
- For non-hospitalized patients with mild-to-moderate COVID-19, antiviral agents such as molnupiravir, remdesivir, and nirmatrelvir/ritonavir may be recommended 4, 5, 6
- For hospitalized patients with severe or critical COVID-19, corticosteroids and tocilizumab may be recommended 3, 4
- For patients who require supplemental oxygen, systemic corticosteroids, remdesivir, tocilizumab, and other treatments may be recommended 4
Efficacy and Safety of Antiviral Treatments
Studies have shown that antiviral treatments such as molnupiravir, remdesivir, and nirmatrelvir/ritonavir have similar effectiveness in containing the progression of COVID-19 and have a good safety profile 5, 6
- Molnupiravir has been shown to reduce hospitalization and mortality risk in outpatients with COVID-19 6
- Remdesivir has been shown to reduce recovery time and improve clinical outcomes in hospitalized patients with COVID-19 3
- Nirmatrelvir/ritonavir has been shown to have potential in preventing the progression of COVID-19 in outpatients, but more data are needed to confirm this finding 6