Should I Take an Antiviral for COVID-19?

WWith the Omicron virus still being widely circulated around the globe, and home COVID-19 tests becoming more popular, many people test positive for SARS-2. That’s leaving them wondering if there is anything they can do to cut down the number of their sick days, and, more importantly, to ​​reduce the chance of getting severely ill. Here’s a breakdown of which treatments are available, who should use them, and when.

Who can get drug treatment for COVID-19?

For now, COVID-19 therapies aren’t meant for the vast majority of people who might test positive. They’re targeted to people with underlying health conditions, who might not have as strong an immune response to the vaccines, or the elderly, all of whom are more vulnerable to getting serious enough symptoms that they might need hospitalization. To determine if the benefits and risks of these treatments are safe and effective, researchers have been studying them.

Are there any drug therapies available for COVID-19 treatment?

There are two main types of drug-based COVID-19 treatments: antivirals or monoclonal antibodies.

Monoclonal antibodyThese compounds mimic immune cells infected by SARS-CoV-2. Because there are enough monoclonal antivirals, the virus will bind to them instead of healthy cells. It can greatly decrease the number of infected healthy cells. They also become factories that produce more virus.

The FDA currently approves four of these therapies:

  • Cligavimab, Tixagevimab
  • Sotrovimab
  • Bamlanivimab & etesevimab
  • Imdevimab, Casirivimab

The Omicron variant can only be protected by the initial therapy.

Antivirals work by interrupting the virus from using a healthy cell’s machinery to copy its genetic material and reproduce. The first COVID-19 antibiotic, remdesivir was approved by the U.S. Food and Drug Administration in October 2020. This medication had been authorized for emergency purposes by Gilead in May 2020. It’s an IV drug that can only be administered at hospitals or infusion clinics.

The FDA approved Paxlovid from Pfizer in December 2021 as the first antiviral medication. Paxlovid actually contains two drugs. One blocks SARS-CoV-2 replication and the other prevents the body’s breakdown of the previous drug too fast. Paxlovid should be used by people who are at risk for developing severe COVID-19, or other life-threatening conditions. The treatment involves three tablets taken twice daily for five days.

One day after issuing authorization for Paxlovid the FDA authorized the Merck second COVID-19-antiviral pill, molnupiravir. This works by making genetic mistakes during the viral copying process. Like Paxlovid and molnupiravir, it is intended for those who are at risk of developing severe COVID-19. The latter requires taking four capsules two times a day for five days.

What are the effectiveness of antibody treatment?

Research to date suggests that monoclonal antibodies can reduce the risk of hospitalization and death by up to 80% compared to people who don’t take the drugs.

These therapies have the problem that SARS-CoV-2 could easily evolve around them. The FDA has authorized four such therapies, but three of them aren’t effective in protecting against the Omicron variant. According to the National Institutes of Health, doctors should only recommend Evusheld by AstraZeneca. It is a mixture of cilgavimab (tixagevimab) and cilgavimab (given in two injections). According to a new study, published April 20, in the journal The. New England Journal of Medicine, researchers led by a team at AstraZeneca found that the company’s two-drug combination reduced the risk of COVID-19 symptoms in vulnerable people by nearly 77% compared to those receiving a placebo.

What are the effectiveness of antiviral treatment?

Paxlovid is also an effective antiviral. Studies show that it can decrease the likelihood of being hospitalized by up to 90% for those most susceptible to infection. Molnupiravir can reduce the likelihood of hospitalizations or death but is less effective when taken within days of symptoms appearing. It’s more efficient if the drug is used sooner in the course, as it has the potential to lower the risk by up to 30% to 50%.

These treatments should be used when appropriate

Because of the way monoclonal antibodies and antivirals work, both need to be taken very close to when a person is infected, preferably even before they experience symptoms—and ideally less than five days after diagnosis or symptoms appear. It is important to get the drug in your body as soon as possible. The more effective they are at overcoming the SARS CoV-2 virus, the less chance it has of taking over your immune system.

The drugs may not be needed for those who aren’t sick enough to require them. However, for those who do get sick, but not immediately after infection, hitting that sweet spot of starting one of these therapies at the right time might be more difficult, since they all require a doctor’s prescription. The Biden Administration’s Test-to-Treat program is meant to streamline access to the drugs, but it hasn’t proven all that effective.

And that’s all just for those most vulnerable to developing severe COVID-19. Most people are capable of recovering from the infection with minimal adverse side effects. However, further research is needed to determine how effective and safe antiviral treatment are.

Those ongoing studies are also looking at Long COVID symptoms, to determine whether longer-lasting effects of even mild disease could have negative effects on people’s health. If that’s the case, that would make a stronger argument for expanding the population that can be treated with COVID-19 therapies.

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