Q: I just contracted Covid. What treatments are available for me?

A: Since my last post on treating Covid at home, there has been a “game changer”! The FDA has authorized several medications for management of acute mild-to-moderate Covid. These new medications can reduce the severity and duration of a Covid infection.

The first was monoclonal antibody therapy , sotrovimab, for those who are at high risk for progression to severe Covid. The cost is over $2000, and the supply is limited. It is also an intravenous therapy, hence this treatment is hard to get. Previous combination products have not been effective against Omicron and are no longer recommended.

In December 2021 Emergency Use Authorization (EUA) was approved for Paxlovid, a combination of nirmatrelvir and ritonavir, marketed by Pfizer. This has had great success in treating mild-to-moderate cases. The medication is taken twice daily for 5 days at a cost of over $500, which is likely covered by insurance.

Molnupiravir received an EUA next. This product, marketed by Merck, has been shown to reduce mortality by as much as 99 percent, and the risk of hospitalization was reduced as much as 51%. It is not as active against the Delta variant, but Omicron is prevalent at this time. This medication is taken as 4 capsules twice daily for 5 days, and the cost exceeds $700.

For more severe cases (for example, those with severe shortness of breath, chest pain, reduced oxygen levels) considerations include Remdesivir, convalescent plasma, tocilizumab, and baricitinib.

Medications that have not been authorized but have shown benefit in some studies include ivermectin (a commonly used anti-parasitic and anti-viral drug), hydroxychloroquine (an anti-malarial that has been found effective in Covid), and fluvoxamine (an anti-depressant that has reduced Covid hospitalizations and mortality).

The point is that there are now medications that can reduce the morbidity and mortality of Covid-19, so if you contract the illness and have more than mild symptoms or if you have other risk factors (for example, hypertension, obesity, diabetes, heart or lung problems) then contact your primary provider and find out which of these treatments is available to you. Dr. Hillman and I have also assisted some of our patients whose primary doctor was unable or unwilling to provide such therapies.