The majority of people who contract COVID-19 don’t need to seek treatment and can typically battle the infection on their own. That’s not always the case, however, especially for those who are high risk and have certain health conditions. In an effort to prevent hospitalization and severe illness, multiple options are available, including antiviral pills and intravenous treatments. The criteria vary widely for each, and depending on your situation, one option may be recommended over the other. Those seeking treatment are advised by the Centers for Disease Control and Prevention to reach out to their health care provider, even if only experiencing minor symptoms. As the BA.5 subvariant continues to circulate and more cases occur, here’s what to know about the treatment options, including eligibility and possible side effects. Paxlovid The latest treatment to garner widespread attention, Paxlovid is an oral antiviral pill that stops viruses from replicating inside the body’s cells and is meant for those currently infected with COVID-19. Paxlovid is available to people ages 12 and up who weigh at least 88 pounds, who have a positive COVID-19 test result, are showing symptoms and are at high risk for developing severe COVID-19, according to an article from Yale Medicine. In older people and other high-risk patients, the drug was shown to reduce the chances of hospitalization or death from COVID-19. The pills work best if taken within five days from when symptoms begin. Research suggests that a minority of those prescribed Paxlovid do experience a rebound case of the virus, such as what happened to President Joe Biden. In those instances, symptoms recurred four or five days after completing the treatment. The CDC in June said a brief return of symptoms may be a natural part of a COVID infection, and not related to Paxlovid. No additional treatment is needed for those who experience a rebound, according to health officials. The drug has been shown to reduce the risk of hospitalization in non-hospitalized patients by 87% when given as a three-day course, according to a study from the New England Journal of Medicine. Paxlovid does interact with many different medications, including blood thinners and cholesterol pills, so make sure your doctor is aware of your current medication list before discussing treatment. Molnupiravir Also known by the brand name Lageviro, Molnupiravir is recommended for people age 18 and up who are at high risk for hospitalization and death from COVID-19. However, it should only be used when Paxlovid, Bebtelovimab and Remdesivir aren’t available, as its efficacy was determined to be lower than originally reported. The medication must be taken as soon as possible, within five days of symptom onset, according to Yale Medicine. Merck, the company behind the drug, initially reported the efficacy as 50%, but later adjusted it to 30%. Those prescribed the medication should take four capsules every 12 hours for five days. Molnupiravir is not recommended during pregnancy, since it has not been studied in pregnant women and has shown potential harm during in vitro studies. While the medication is still being studied and all of the risks may not be known, the most common side effects are diarrhea, nausea and dizziness. Other Possible Treatments Remdesivir The first drug approved to treat COVID-19 in late 2020, Remdesivir is the only antiviral treatment to receive full Food and Drug Administration approval – at least so far. Other treatments, including Paxlovid and Molnupiravir, are available under Emergency Use Authorization through the FDA. Approved for both children and adults, Remdesivir is administered intravenously or through injection and must be given in a health care setting. To receive the treatment, infants and children must be at least 28 days old, weigh over 6.5 pounds and be either hospitalized or at high risk for severe illness. While nausea is the most common side effect, hypersensitivity, including infusion-related and anaphylactic reactions, have occurred following treatment in some instances, according to Yale Medicine. Given both in an outpatient and hospital setting, the drug inserts itself into new viral genes to block replication of the virus, shortening the time it takes seriously ill patients to recover. Monoclonal Antibodies While data has shown not all monoclonal antibody treatments have worked against all COVID-19 variants, some have been deemed effective in combating the omicron strain. Bebtelovimab, which was authorized in February, is available for adults and children ages 12 and up who weigh at least 88 pounds and are at high-risk for developing severe COVID-19. An intravenous injection is given for at least 30 seconds, according to health officials, which stated the drug must be given within seven days of symptom onset. Considered to be an alternative treatment by the National Institutes of Health, it should only be used in cases where Paxlovid or Remdesivir aren’t available or appropriate. Another monoclonal antibody, Evusheld, serves a different purpose. Unlike the aforementioned treatments, it serves to keep immunocompromised people who don’t respond to vaccination from getting sick, according to Yale Medicine. Available to anyone 12 years and older and 88 pounds, the drug shouldn’t be given to those with an active infection or anyone who was recently exposed. Doses will be given in the buttocks, during two separate injections, one after another, with repeat doses every six months. Hypersensitivity, bruising, swelling, pain and soreness at the injection site are possible after the shot is given.
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