COVID-19 Treatments

People who are positive for COVID-19 and have one or more medical condition that increases their risk of becoming very sick or another serious outcome from COVID-19 may be eligible for treatment.

People who are positive for COVID-19 and have one or more medical condition that increases their risk of becoming very sick or another serious outcome from COVID-19 may be eligible for treatment.

• Older adults are at the highest risk of getting very sick from COVID-19. The number of deaths among people over age 65 is 97 times higher than the number of deaths among people aged18to 29 years.
• Some people are at increased risk of getting very sick or dying from COVID-19 because of where they live, work or due to lack of access to health care. This includes many people from racial and ethnic minority groups and people with disabilities.
• Studies have shown people from racial and ethnic minority groups are also dying from COVID-19 at younger ages. People in racial and ethnic minority groups are often younger when they develop chronic medical conditions and may be more likely to have more than one medical condition.
• A study published in January 2022, revealed Black, Hispanic, Asian and ‘Other’ race patients received therapy to treat severe COVID-19 disease, such as monoclonal antibody therapy, less often than did White patients during the period from November 2020to August 2021.
• People with disabilities are more likely than those without disabilities to have chronic health conditions or live in shared group (also called “congregate”) settings. They also face more barriers in accessing healthcare. Studies have shown some people with certain disabilities are more likely to get COVID-19 and have worse outcomes.

If you are at higher risk than most for increased illness or complications from COVID-19 due to a medical condition or other reason, your healthcare provider may recommend one of the following treatments:

• Monoclonal antibody treatments
• Oral antiviral medications

The National Institutes of Health (NIH) currently (April2022) recommends one of the following treatments (listed in order of preference) for patients who are not hospitalized but have mild to moderate COVID-19 disease and are at high risk of progressing to severe disease:

• Paxlovid (oral tablet, antiviral)
• Remdesivir (IV infusion, antiviral)

If the above treatments are unavailable, not easy to deliver, or are not appropriate for the patient (forexample, because they may interact with other medicines the patient is taking), then one of the following treatments may be substituted:

• Bebtelovimab (IV infusion, monoclonal antibody)
• Molnnupiravir (oral tablet, antiviral)

As scientists learn more, guidance may change.

Stay informed at https://www.covid19treatmentguidelines.nih.gov/therapies/.

Contact a health professional if you test positive for COVID-19 to find out if you may be eligible for treatment. It is best to do so even if your symptoms are mild. Treatment must be started within the first few days of becoming infected to help you.

If you have symptoms, your healthcare provider may recommend certain therapies to help relieve symptoms or to support your body’s immune system. These include:

• Medications to reduce fever (such as acetaminophen or ibuprofen).
• Staying hydrated: drinking water or, if necessary, receiving intravenous fluids at a healthcare facility
• Getting plenty of rest to help the body fight the virus.

Monoclonal antibody treatments and antiviral treatments are not a substitute for receiving COVID-19 vaccination and COVID-19 booster doses.

Vaccines are given to prevent infection. It takes up to 2 weeks after getting a COVID-19 vaccine to begin receiving protection.

The goal of giving someone a COVID-19 vaccine is to train a healthy immune system to protect from a future COVID-19 Infection by developing antibodies (fighting cellsagainst the spike protein). For several months after COVID-19 vaccination, your body continues to produce these fighting cells. Protection from vaccines may last months to years.

Get your COVID-19 vaccine and booster dose(s) if eligible. For further details, visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

• COVID-19 monoclonal antibodies help to prevent someone who has tested positive for COVID-19 and is at high risk of getting worse, from getting severely ill from COVID-19 disease and becoming hospitalized.
• COVID-19 monoclonal treatments work by giving your body antibodies (fighting cells) to fight off the spike protein (antigen) from the Covid-19 virus. Thesemonoclonal antibodies attach to the spike protein of the virus so the virus will not work. They allow our body’s immune system to recognize and respond better to the virus.
• COVID-19 monoclonal antibodies work best when given to someone with a positive test as soon as possible or within five to seven days of when they develop any symptoms of COVID-19. Some COVID-19 monoclonal antibodies may not work as well if someone is already severely ill, in the ICU or on a ventilator.
• Your healthcare provider will decide whether COVID-19 monoclonal antibodies are appropriate to treat your illness. You will need a doctor’s prescription to receive monoclonal antibodies.
• Some monoclonal antibodies may not work as well against variants. The FDA continues to monitor all authorized monoclonal antibodies to see if they will work against COVID-19 variants, including the Delta and Omicron variants and subvariants.
• For people with breakthrough infections (meaning developing COVID-19 disease after having had the COVID-19 vaccination), monoclonal antibodies may be considered by the healthcare provider.
• Monoclonal antibodies are NOT vaccines.
• Some scientists believe protection from monoclonal antibodies may last up to a monthor longer. Scientists are still learning the duration of protection.
• In some rare circumstances, your healthcare provider may recommend monoclonal antibodies, such as Evushield (PrEP), to reduce the risk of infection prior to (download a PDF about pre-exposure prophylaxis or PreP) or after exposure(post-exposure prophylaxis). For more details, visit: NIH PrEP and PEP.

Oral antiviral medications can be used to reduce the ability of the virus to multiply and spread through the body by targeting specific parts of the COVID-19 virus.

The following two oral medications are recommended by the NIH in order of preference:

• Paxlovid (Ritonavir-boosted nirmatrelvir)
• Molnupiravir

Lagevrio (Molnupiravir)is authorized by the U.S. Food and Drug Administration (FDA)for the treatment of mild to moderate COVID-19 in adults at high risk of progressing to severe disease, and for whom alternative antiviral therapies are not accessible or clinically appropriate.

Who is eligible to receive Lagevrio (Molnupiravir)?

People who:

• Are18 years and older and have mild to moderate COVID-19 disease
• Are not hospitalized
• Have tested positive for SARS-CoV-2, are at high risk for progression to severeCOVID-19, including hospitalization or death.

* Molnupiravir should only be used when Paxlovid or Remdesivir cannot be used instead.

How is Lagevrio (Molnupiravir) given? How does the medicine work?

• The name of the medication is Lagevrio. The generic name is Molnupiravir. It is manufactured by Merckand Co., Inc.
• The medicine is available by prescription only from a licensed healthcare provider. Take the medicine by mouth as prescribed.
• It is recommended to take Molnupiraviras soon as possible after being diagnosed with COVID-19 and within the first five days of developing symptoms.
• The medicine works by attacking the COVID-19 virus.
• EUA Fact sheets that provide important information about using Molnupiravirare available as PDF downloads for healthcare providers and patients and caregivers. These fact sheets include dosing instructions, potential side effects, drug interactions and information about who can and cannot take Molnupiravir.

Are there people who should not take Lagevrio (Molnupiravir)?

• People who are allergic to Lagevrio (Molnupiravir) or its ingredients.
• Lagevrio (Molnupiravir) is not recommended for use in pregnant people. It may affect the developing baby.

In December 2021, the FDA issued an EUA (Emergency Use Authorization of an unapproved medication) for the first two oral antiviral treatments, Paxlovid and Lagevrio (Molnupiravir), to treat mild to moderate COVID-19 disease. Paxlovid and Molnupiravirare not a substitute for receiving COVID-19 vaccination and a COVID-19 booster dose.

Who is eligible to receive Paxlovid?

People who:

• Are 18 years and older and children 12 years and older (who weigh at least 40 kg (88pounds) and have mild to moderateCOVID-19 disease
• Are not hospitalized
• Have tested positive for SARS-CoV-2 testing, are at high risk for progression to severe COVID-19, including hospitalization or death.

How is Paxlovid given? How does the medicine work?

• The name of the medication is Paxlovid (generic Nirmatrelvir tablets and Ritonavir tablets, co-packaged for oral use). It is manufactured by PfizerLabs.
• The medicine is available by prescription only from a licensed healthcare provider. Take the medicine as prescribed by mouth.
• It is recommended to take Paxlovid as soon as possible after being diagnosed with COVID-19 and within the first five days of developing symptoms.
• The medicine works by stopping one of the proteins in the COVID-19 virus from replicating (making copies of itself).
• EUA Fact Sheets that provide important information about using Paxlovid are available for healthcare providers and patients and caregivers. These fact sheets include dosing instructions, potential side effects(such as diarrhea, muscle aches),drug interactions and information about who is able to prescribe Paxlovid.

Are there people who should not take Paxlovid?

• People who are allergic to Paxlovid or any of its ingredients.
• Paxlovid may also interact with certain other medications. It is best to inform your healthcare provider of any medical conditions you have and of any medicines you are taking (including herbal and over-the-counter medications) before taking Paxlovid. Your healthcare provider will then carefully review this to ensure you can safely take Paxlovid.
• People with chronic medical conditions, including kidney or liver disease, hepatitis, or HIV disease, should first check with their healthcare provider to see if they may take Paxlovid.

In patients with severe COVID-19, the body’s immune system may overreact to the threat of the virus, worsening the disease. This can cause damage to the body’s organs and tissues. Some treatments can help reduce this overactive immune response.

• Antivirals administered through an IV infusion (Remdesivir) may be recommended by their doctor for patients who are hospitalized.
• Convalescent plasma, plasma from patients who have recovered from COVID-19, can contain antibodies(fighting cells)to the virus. This could help the immune system recognize and respond more effectively to the virus, but currently, the NIH only recommends the use of convalescent plasma for select individuals who are hospitalized and are severely immunocompromised.
• COVID-19 can damage the heart, blood vessels, kidneys, brain, skin, eyes, and gastrointestinal organs. It also can cause other complications. Depending on the complications, additional treatments might be used for severely ill hospitalized patients, such as steroids to control inflammation and blood thinners to prevent or treat blood clots.

• HHS Test to Treat website
• HHS Test to Treat fact sheet
• HHS Test to Treat FAQs
• HHS Test to treat infographic