With the high transmissibility of the Omicron variant of SARS-COV-2, many people are wondering what therapies are available once someone has been infected in order to prevent severe illness and/or hospitalization. Dr. David Fletcher has been speaking about COVID, vaccines, and treatments throughout the pandemic and has gathered the most up to date information about medications that can be given to help those who have contracted COVID. These are the approved treatments currently available:
Anti-viral medications Patients take two tablets of Paxlovid (nirmatrelvir) with one tablet of another antiviral called Ritonavir (Ritonavir is an antiretroviral protease inhibitor that is widely used in combination with other protease inhibitors in the therapy and prevention of HIV infection) twice a day for five days. Right now, it is hard to get Paxlovid but not impossible. The Ritonavir is co-packaged with the nirmatrelvir (Paxlovid) Paxlovid is intended for those with mild or moderate COVID-19 who are more likely to become seriously ill. That includes older people and those with other health conditions like heart disease, cancer or diabetes that make them more vulnerable.
Monoclonal Antibodies This week, the FDA pulled authorization on the two most-used monoclonal antibody treatments (Regeneron & bamlanivimab) because they do not work against the Omicron variant, which now causing almost 100% of infections across the U.S. Fortunately, there’s a new monoclonal formulation that does work on Omicron: Sotrovimab, which requires IV infusion and takes longer than Regeneron did to administer it. It is available. Time is of the essence with the treatment, which only works early in the infection. Monoclonal antibodies are only authorized for use in the 10 days after symptoms appear.
Remdesivir is an injectable antiviral, was recently authorized for outpatient use via infusion. Previously, Remdesivir was reserved for hospitalized patients. It’s not being used regularly because it’s more complicated to administer, requiring three visits to the infusion clinic versus one visit for monoclonal antibodies.
Fluvoxamine 100 mg of fluvoxamine three times daily for 15 days lowers likelihood of clinical deterioration over 15 days. This if off-label use of this drug that is used for obsessive compulsive disorders. Fluvoxamine may prevent clinical deterioration by stimulating the σ-1 receptor, which regulates cytokine production and stops “cytokine storm” caused by COVID-19 that leads to respiratory distress and death.
While most people can recover at home without these therapies, knowing that they are available can help people who are infected make decisions about seeking these treatments if they are at high risk for severe infection or hospitalization.