What are the antiviral medications for Coronavirus disease (COVID-19)?

From the Guidelines

Remdesivir is the recommended antiviral medication for patients with severe COVID-19, as suggested by the World Health Organization 1. This recommendation is based on the living WHO guideline on drugs for COVID-19, which suggests treatment with remdesivir for patients with severe COVID-19 1. Some key points to consider when prescribing remdesivir include:

• It is administered intravenously over three days
• It has been shown to inhibit SARS-CoV and MERS-CoV in vitro and in vivo experiments 1
• Data from compassionate use of remdesivir showed that 68% of severe COVID-19 patients showed clinical improvement 1
• Preliminary data from another randomized controlled trial in the USA, Korea, and other countries showed that remdesivir could shorten the time to recovery in adults hospitalized with COVID-19 and evidence of lower respiratory tract infection 1 Other antiviral medications, such as lopinavir/ritonavir, hydroxychloroquine, and molnupiravir, have also been studied, but their effectiveness and safety profiles vary 1, 1, 1. For example, lopinavir/ritonavir has been shown to have no clinical benefit in patients with COVID-19 and may have adverse effects 1, while hydroxychloroquine has been shown to have an inhibitory effect on SARS-CoV-2 in vitro experiments, but its effectiveness in clinical trials is still unclear 1. Molnupiravir, on the other hand, has been shown to be less effective than remdesivir in shortening the time to recovery in adults hospitalized with COVID-19 1. It's essential to note that treatment decisions should be individualized based on risk factors, timing of symptom onset, and potential drug interactions 1, 1, 1, 1. Additionally, the use of antiviral medications should be guided by the most recent and highest-quality evidence, and clinicians should be aware of the potential for drug interactions and adverse effects 1, 1, 1, 1.

From the FDA Drug Label

VEKLURY is a prescription medicine used for the treatment of coronavirus disease 2019 (COVID-19) in adults and children weighing at least 3 pounds (1. 5 kg) who are: 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 antiviral medication for Coronavirus disease (COVID-19) is Remdesivir (IV), also known as VEKLURY.

• Key points:
  • Used for the treatment of COVID-19 in adults and children weighing at least 3 pounds (1.5 kg)
  • Indicated for hospitalized patients or non-hospitalized patients with mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19 2
  • Administered via intravenous (IV) infusion 2
  • Dosage: 200 mg on Day 1 and 100 mg once daily on subsequent days for up to 10 days for hospitalized patients, and 200 mg on Day 1 and 100 mg once daily for 3 days for non-hospitalized patients 2

From the Research

Antiviral Medications for COVID-19

• Remdesivir is an antiviral medication approved for the treatment of COVID-19, with broad-spectrum antiviral activity 3, 4, 5, 6.
• Remdesivir has been shown to reduce the time to recovery and improve clinical outcomes in hospitalized patients with moderate to severe COVID-19 3, 4, 5.
• The medication has also been found to be effective in reducing the risk of clinical worsening and mortality in hospitalized patients with COVID-19 3, 4, 5.
• In non-hospitalized individuals with mild COVID-19, remdesivir has been shown to reduce the risk of clinical worsening and hospitalization 5.
• Other antiviral medications, such as interferon beta-1b, have been studied in combination with remdesivir for the treatment of COVID-19, with promising results 7.
• Monoclonal antibody combinations, such as bamlanivimab/etesevimab and casirivimab/imdevimab, have also been approved for the treatment of COVID-19 in non-hospitalized patients with mild-to-moderate disease at high risk of progression 6.

Key Findings

• Remdesivir is a useful treatment option for patients with COVID-19, particularly those who require supplemental oxygen 3.
• The medication has a low potential for drug-drug interactions and is generally well-tolerated in clinical trials 3, 4.
• However, pharmacovigilance data have found an increased risk of hepatic, renal, and cardiovascular adverse drug reactions in the real-world setting 3.
• Further studies are needed to provide additional data on the efficacy and safety of remdesivir for defined core outcomes in COVID-19 research, especially for different population subgroups 5.