COVID-19 Treatment

Getting a COVID-19 vaccine and practicing layered prevention (such as wearing a mask in public indoor settings, social distancing, staying home when sick, avoiding indoor crowds and frequently washing your hands) is the best way to avoid becoming seriously ill with COVID-19. 

Many people who do become ill with COVID-19 will experience mild symptoms and can recover at home by following symptomatic treatment like getting plenty of rest and fluids and using Tylenol, Ibuprofen, decongestants, and other over-the-counter cold and flu medications to alleviate fever and symptoms. Since COVID-19 can become serious it is important to monitor symptoms carefully. Signs that you may need help from a medical professional include panting or difficulty breathing, difficulty keeping fluids down or urinating, high fever, rapid pulse, a pulse ox below 90, and/or elevated blood pressure. In a medical emergency, call 9-1-1.  

Those who are at high risk of developing severe illness should seek treatment right away after testing positive for COVID-19 (see below). Getting a vaccine and practicing layered prevention is best way to prevent serious illness, hospitalization and death from COVID-19. 

Outpatient (Non-hospitalized) Treatment for COVID-19

Oral Antivirals

Oral antivirals are pills that can help treat COVID-19. There are currently two types of oral antiviral pills that have been authorized by the U.S. Food and Drug Administration (FDA) under emergency use authorization (EUA): Paxlovid and Molnupriavir. 

PAXLOVID
PAXLOVID is an oral antiviral treatment developed by Pfizer for COVID-19. PAXLOVID is available by prescription only and should be taken as soon as possible after diagnosis and within five days of when a person develops symptoms.

Molnupiravir 
Molnupiravir is an oral antiviral treatment developed by Merck for COVID-19. Molnupiravir is available by prescription only and should be taken as soon as possible after diagnosis and within five days of when a person develops symptoms.  

How can I receive oral antivirals?

Talk to your doctor  as soon as possible after you test positive for COVID-19 to see if you are a good candidate for antiviral treatment. Antivirals are available by prescription only. 

Am I eligible for oral antivirals?

The U.S. Food and Drug Administration has issued an emergency use authorization for PAXLOVID and Molnupiravir. Right now, oral antivirals are authorized for people who: 

  • Are age 12 years or older for Pfizer’s Paxlovid or age 18 years or older for Merck’s molnupiravir, and  
  • Have tested positive for COVID-19, and 
  •  Have had symptoms for less than 5 days, and 
  • Are not hospitalized, and  
  •  Are at high risk of becoming seriously ill. People at at high risk of becoming seriously ill from COVID-19 include: 
    •  People who are 65 years old or older. 
    •  People who are obese or overweight. This includes adults with a BMI of 25 or more. It also includes children under age 18 years old whose providers determine they meet the criteria. 
    • Pregnant people (for Paxlovid only). 
    • People with certain underlying medical conditions. 

See the How Do I Know If I’m High Risk, and What Do I Do Next? page on CombatCOVID.hhs.gov to learn more. 

Oral antivirals to treat COVID-19 are not a substitute for vaccination against COVID-19. Getting vaccinated is the best way to keep from getting sick with COVID-19. 

How do oral antivirals work?

PAXLOVID 

PAXLOVID is made up of two drugs: nirmatrelvir, which works by slowing the virus’ ability to replicate within the body, and ritonavir, which helps nirmatrelvir stay in the body longer. PAXLOVID is administered as three tablets which are taken together orally twice daily for five days, for a total of 30 tablets. 

Molnupiravir 

Molnupiravir works by slowing the virus’ ability to replicate within the body and is administered as four 200 milligram capsules taken orally every 12 hours for five days, for a total of 40 capsules. 

Do oral antivirals have side effects?

Side effects are possible and it is important to discuss this possibility with your doctor or health care provider. 

PAXLOVID 

Possible side effects of PAXLOVID include impaired sense of taste, diarrhea, high blood pressure and muscle aches. Ask your doctor about the potential for serious drug interactions, liver damage or drug resistance. Patients with kidney or liver problems should discuss with their health care provider whether PAXLOVID is right for them. 

Molnupiravir

Possible side effects of Molnupiravir include diarrhea, nausea, and dizziness. Molnupiravir is not recommended for use during pregnancy. Pregnant people should only take molnupiravir if their heatlh care provider decides that the benefits out weigh the risks. If you are pregnant, may become pregnant, or are breastfeeding, it’s important to talk to your health care provider about your specific situation. If you have general questions about side effects or whether Molnupiravir is right for you, talk to your doctor. 

Monoclonal Antibody Treatment

COVID-19 Monoclonal Antibodies are currently under Emergency Use Authorization from the US Food and Drug Administration (FDA). They are the only authorized drug to treat COVID-19 in patients who are not hospitalized (outpatients) who are at risk of developing severe COVID-19 symptoms. Those who are hospitalized or using oxygen to treat COVID-19 are not eligible to receive monoclonal antibodies. 

Monoclonal antibodies are laboratory-made molecules that act as a substitute for the natural antibodies your own body produces after being vaccinated or after being exposed to COVID-19 and recovering. They are administered either through a single intravenous treatment that takes approximately one hour or through four injections administered during one visit. Both methods are followed by one hour of observation. 

There are three treatments authorized by the FDA: 

  • Bamlanivimab and etesevimab 
  • Regeneron 
  • Sotrovimab 

Am I eligible for Monoclonal Antibody Treatment?

Monoclonal antibody treatments are available for patients 12 and older who weigh at least 40 kilograms/88 pounds, test positive for COVID-19 with an onset of symptoms within 10 days, who are not hospitalized, but who are at high risk of developing severe COVID-19. Individuals must meet screening criteria to be eligible. Find out more at the links below.

Are you eligible for monoclonal antibody treatment?
CDPHE: Learn more about monoclonal antibodies

Where can I receive Monoclonal Antibody Treatment?

Currently, local providers offering monoclonal antibody treatment to select patients who meet criteria include:  

  • UCHealth 
  • Centura
  • Future Innovative Treatments
  • CDPHE maintains a list of all providers administering monoclonal antibody treatments at covid19.colorado.gov. 

There is increasing demand for monoclonal antibodies but limited supplies. The U.S. Department of Health & Human Services (HHS) is equalizing distribution across states and plans to distribute doses to public health agencies to distribute to local providers. Bamlanivimab/etesevimab and regeneron are free for recipients, while storovimab is covered by Medicaid, Medicare and many health insurance plans. 

NOTICE: While the medication itself, as noted above, is provided without cost to the consumer through the Federal Governments purchase,  there may fees incurred for the provider resources and facility. Please discuss your insurance and billing details with your selected provider.

Are there other treatments for outpatient COVID-19?

No.

Monoclonal antibodies are the only treatment authorized by the FDA for the treatment of COVID-19 in an outpatient (non-hospitalized) setting though trials for other treatments are underway.

ATTENTION: THE FOLLOWING ARE NOT TREATMENTS FOR COVID-19 AND MAY ENDANGER YOUR HEALTH!

• Ivermectin: Ivermectin isn't a drug for treating viruses and the FDA has NOT approved this drug to treat or prevent COVID-19. Taking large doses of this drug can lead to serious harm. Please do not use drugs intended for animals.

• Hydroxychloroquine and chloroquine: These malaria drugs were authorized for emergency used by the FDA during the COVID-19 pandemic. However, the FDA withdrew that authorization when data analysis showed that the drugs are not effective for treating COVID-19. They can also cause serious heart problems.

Resources

Flyer: Positive for COVID-19? MONOCLONAL ANTIBODY TREATMENT Can Prevent a Mild Case from Becoming Worse

Inpatient (Hospitalized) Treatment for COVID-19

About Convalescent Plasma

Convalescent Plasma is antibodies derived from those who previously had a COVID-19 infection. It can be used for both mild-moderate and severe infections in hospitalized patients. Unfortunately, it has been shown to have little benefit to patients in the most recent studies and is rarely used.

About Remdesivir

Remdesivir is an antiviral drug that is available for adult and some pediatric hospitalized COVID-19 patients. It is delivered exclusively by IV.

About Dexamethasone

Dexamethasone is a steroid used for hospitalized COVID-19 patients who require increasing amounts of supplemental oxygen and who are showing widespread inflammation. It is often used in combination with Remdesivir.

About Anticoagulants

Anticoagulants are used in hospitalized COVID-19 patients on a case-by-case basis to prevent blood clots from forming. Because anticoagulants can allow excess bleeding in patients, doctors must carefully weigh the risk of using this class of drugs.