Not every case of COVID-19 is the same. For some people, it can be like a cold or the flu. But for others, getting the coronavirus can result in hospitalization, long-haul COVID-19 symptoms or worse.
Fortunately, there are treatments that may reduce the chance of severe COVID-19. Below, we cover the details and if they may be an option for you.
Who’s at risk for severe COVID-19?
While there’s no way to know for certain, you’re more likely to get severe COVID-19 if:
- You’re unvaccinated. If you’re unvaccinated, you’re more likely to die from COVID-19, according to data from the Centers for Disease Control and Prevention (CDC).
- Your protection against COVID-19 has diminished. If you had a COVID-19 vaccine or were sick with the coronavirus, your body developed antibodies to protect you from getting sick. But this protection lessens over time and may not protect against newer variants of the coronavirus. So if you haven’t gotten the latest COVID-19 vaccine, you may no longer have the protection you need.
- You have a weaker immune system. If you’re moderately to severely immunocompromised you may not have built up enough immunity to COVID-19 even after getting vaccinated.
- You have a chronic health condition. Obesity, diabetes, kidney disease, cardiovascular disease, high blood pressure and lung disease can increase your chance of developing severe symptoms.
- You’re over the age of 65. Getting older increases your risk of COVID-19. According to the CDC, the number of COVID-19 deaths for people 65 years and older is 97 times higher than for those between the ages of 18 and 29.
Ways to reduce the chance of severe COVID-19 symptoms
Scientists continue to work on new treatments, medicines and methods to help reduce or prevent severe COVID-19 symptoms that could lead to hospitalization. Below, we provide information about the pills from Pfizer and Merck, the antiviral drug remdesivir and monoclonal antibodies.
COVID-19 pills
Two COVID-19 antiviral pills are available for people who have mild to moderate COVID-19 and who are at risk of progressing to severe disease. These pills are nirmatrelvir/ritonavir (Paxlovid) from Pfizer and molnupiravir (Lagevrio) from Merck and Ridgeback Biotherapeutics. Only Paxlovid is available through HealthPartners.
What are the differences between the Merck COVID-19 pill and the Pfizer COVID-19 pill?
- Who can get them. The Paxlovid pill can be used by people 12 years of age or older. Lagevrio is for adults only and should not be used during pregnancy.
- Effectiveness of the treatments. When given to people with COVID-19 who had a high chance of progressing to severe illness, both pills reduced the likelihood of hospitalization and death. But the Pfizer pill was more effective – 85% reduction with Paxlovid compared to 30% with Lagevrio.
- How they work. Paxlovid stops the virus from replicating in your body by blocking a specific protein. Lagevrio creates multiple mutations of the virus within your body, making it difficult for it to continue to reproduce. Because the drugs don’t attack the spike protein, the part of the virus that changes the most with each variant, scientists hope that these drugs continue to work against future COVID-19 variants.
- Side effects. The side effects of the COVID-19 pills are generally mild. The most common side effects of Paxlovid are a metallic taste in your mouth and diarrhea. Common Lagevrio side effects include diarrhea, nausea and dizziness. Other side effects of COVID-19 pills include high blood pressure, headaches, rashes, insomnia and flu-like symptoms. It’s also possible to have an allergic reaction to COVID-19 pills. And since the COVID-19 pills are still new, there’s a chance that not all side effects are known.
- Who can take them. Paxlovid may not be appropriate if you have liver or kidney problems, or are being treated for an HIV-1 infection. With Lagevrio there are concerns about mutations and birth defects.
What’s the COVID-19 pill treatment like?
You’ll need to take 3-5 pills, twice a day for five days.
When are the COVID-19 pills used?
Treatment begins after a confirmed COVID-19 case, preferably within five days of the first COVID-19 symptoms. So if you start to experience symptoms, do a rapid antigen test at home or make an appointment to get a PCR test – the most accurate type of COVID-19 testing – as soon as possible.
How can I get COVID-19 antiviral pills?
You’ll likely need to meet certain requirements before getting the medication. If you’ve tested positive for COVID-19 at a HealthPartners clinic and are at high risk for COVID-19, you’ll be receiving a call from us to talk about your treatment options. If you’ve received a positive COVID-19 test result from a home test, call your clinic.
Antiviral drug remdesivir
What is remdesivir? Remdesivir is another type of antiviral medication. In a clinical study, using remdesivir within one week of developing COVID-19 symptoms significantly reduced a person’s risk of progressing to severe illness, hospitalization or death.
Who can get the remdesivir drug?
Remdesivir was the first medication that the FDA approved to treat patients hospitalized with COVID-19 symptoms. But now, remdesivir can be used for non-hospitalized people with mild to moderate symptoms who are at high risk of progressing to severe COVID-19. This medication can be used for both adult patients and pediatric patients who weigh at least 3.5 kilograms (about 8 pounds).
How does remdesivir work?
Remdesivir stops the duplication of the virus inside infected cells. It does this by inserting itself into the coronavirus RNA strand, or the genetic code for the virus.
Because remdesivir targets a specific part of the coronavirus that scientists believe won’t change much with newer variants, the medication should continue to be effective against both current and future versions of COVID-19.
When is remdesivir treatment used?
Remdesivir tends to work best in the beginning stages of COVID-19 infection when the virus is working hard to replicate itself in your body. Ideally, outpatient remdesivir treatment should start within seven days of infection.
Remdesivir can also be used to treat adults and children who’ve been hospitalized with COVID-19. In this situation, you may receive up to 10 doses of remdesivir for your symptoms.
Remdesivir treatment is delivered through intravenous infusion using a vein in your arm. You’ll need three doses so treatment with remdesivir can be a time commitment as you’d need to go to the clinic or hospital for three days in a row. And depending on how much medication you need, each infusion can take between 30 minutes and 2 hours.
What are remdesivir side effects?
Because remdesivir is delivered through your vein, you could have side effects similar to any infusion, such as low blood pressure, nausea, vomiting, sweating and shivering.
Remdesivir can sometimes cause increased levels of liver enzymes, which can be a sign that your liver cells have been damaged or are inflamed. However, your doctor will do blood tests before giving you remdesivir to help you, and your liver, stay safe.
Remdesivir may not work in patients who take certain medications such as hydroxychloroquine sulfate or chloroquine phosphate. There may be other side effects or reasons why remdesivir isn’t right for you. Talk to your doctor about your options.
How can I get treated with remdesivir as an antiviral for COVID-19?
If you get treated at a HealthPartners hospital because you have a severe case of COVID-19, you may receive remdesivir for your symptoms. We are not able to offer remdesivir as an outpatient treatment at this time.
Long-acting monoclonal antibodies
When there’s a virus like COVID-19 in your body, your immune system makes antibodies to fight it off. But it takes time. So if your immune system is compromised, you may get very sick with COVID-19 before your immune system has built up the antibodies you need.
Monoclonal antibodies are lab-made antibodies that can be used to provide added protection against a virus, so people don’t get as sick. Currently pemivibart (Pemgarda) is the only monoclonal antibody available for COVID-19.
When are long-acting monoclonal antibodies used?
Long-acting monoclonal antibodies like Pemgarda are different from the other medications on this list because they are used as a preventive medicine before you get sick or are exposed to COVID-19.
Who can get long-acting monoclonal antibodies?
Pemgarda (pemivibart) may be an option for adults and adolescents over 12 years old, and who are moderately or severely immunocompromised because of a medical condition or because they take medications or receive treatments that suppress the immune system.
Long-acting monoclonal antibody treatment doesn’t replace the need for the COVID-19 vaccine. Rather, it provides additional protection to people who still have a higher risk of getting severe COVID-19 even after vaccination, or those who are unable to get vaccinated for a medical reason.
How do long-acting monoclonal antibodies work?
When you have monoclonal antibody treatment, your doctor gives you lab-made antibodies designed to work like the ones that your body makes. Because you get the lab-made antibodies before you’re exposed to COVID-19, your body is better prepared to fight off the virus if you encounter it .
Pemgarda is given as an intravenous infusion. The added protection from a single dose of Pemgarda provides additional protection for about three months.
What are Pemgarda’s side effects
You may have tiredness, headache, nausea and infusion site reactions. While rare, it’s also possible to have a serious allergic reaction (anaphylaxis) that can affect your ability to breathe. To make sure you’re safe, your doctor will watch for signs of anaphylaxis during the infusion and for two hours afterwards.
How can I get long-lasting monoclonal antibody treatment for COVID-19?
Talk to your doctor to find out if this treatment makes sense for you. If your doctor thinks you’re at high risk of getting severe COVID-19, they may recommend that you get long-acting monoclonal antibody treatment with Pemgarda.
Reduce your chance of severe COVID-19 symptoms
Even as the coronavirus continues to change, one thing remains the same: The COVID-19 vaccine is still protecting people from severe illness. The best thing you can do to protect yourself from severe illness is to get an updated COVID-19 vaccine when it becomes available (usually in September). And if you or your children have tested positive for COVID-19 and are at high risk of getting severe COVID-19, talk to your doctor about options to keep a mild case from getting worse.