1/25/2022: This blog has been updated to reflect new approval and authorization from the FDA for the antiviral drug remdesivir.

The best way to fight COVID-19 is to avoid getting it in the first place. That means wearing a well-fitting mask, keeping gatherings small and outdoors if possible and getting vaccinated (including a booster dose if eligible.) 

But the virus is still spreading widely, so even if you do follow every safety protocol you still might become infected, and potentially severely ill. 

Although most cases of COVID-19 don’t require hospitalization, some people have conditions that increase their risk of severe infection, such as asthma, diabetes, or heart disease. They may also be on medications that weaken their immune systems or have a chronic illness that might worsen the effects of COVID-19. The CDC has a comprehensive list of certain medical conditions that make someone higher risk. 

For these people, there are several COVID-19 treatments available: 

Oral Antiviral treatments from Pfizer, Merck 

The FDA recently approved two oral antiviral medications that dramatically reduce the chances of hospitalization, but they must be administered as soon as possible after a positive COVID-19 diagnosis and within the first five days of symptoms to be effective.  

• Paxlovid (from Pfizer) works by disrupting the virus’s ability to mutate. It specifically targets an enzyme that helps certain viral proteins form correctly.  
• Molnupiravir (from Merck) works by introducing mutations directly into the virus’s genetic makeup. As the virus copies itself, it gets so mutated that it can no longer function. There are some safety concerns because it alters the virus’s genetic information. Some experts worry about adverse effects, especially in pregnant people and in children.  

Because of nationwide shortages, neither of these medications is widely available. Do not go to the emergency room seeking these medications if you don’t require emergency care. If you’re experiencing symptoms, check with your regular doctor if you have one, or visit an urgent care clinic.

Remdesivir

The antiviral drug remdesivir also acts on the virus’ genetic material, blocking its ability to mutate. Remdesivir (also known as its brand name, Veklury) was first approved in October 2020 for COVID-19 patients ages 12 and older requiring hospitalization. On January 21, 2022, the FDA amended its approval to include COVID-19 patients ages 12 and older who do not require hospitalization but are at risk for severe disease. Additionally, the FDA has authorized remdesivir for pediatric patients younger than 12 years old, weighing at least 3.5 kg (about 7 pounds).

Monoclonal Antibodies 

Monoclonal antibodies work by mimicking one of your body’s immune responses. When your immune system detects a foreign invader like a virus, it unleashes antibodies. Those antibodies latch onto the virus, telling your immune system which cells to destroy. 

Monoclonal antibodies are created in a lab and are administered via injection directly into the bloodstream, or into an arm or other area on the body like a shot.  

There are several currently authorized monoclonal antibody treatments available in the U.S., and they each work slightly differently. However, only one, called Sotrovimabv, seems to be effective against the Omicron variant. 

Only certain people can receive monoclonal antibodies. See the chart below for eligibility guidelines. 

(Chart from: https://combatcovid.hhs.gov/i-have-covid-19/how-do-i-know-if-im-high-risk)