COVID-19 treatments: antivirals or antibodies?

As COVID-19 cases become more prevalent in the general population, you may need to understand the available treatments. From a public health perspective, prevention is preferred over treatment so it is still important to continue masking, maintaining distance from others, and staying up to date with vaccinations.

Around 80% of the population have mild symptoms and can recover safely at home.

If you have moderate or severe symptoms, your treatment will depend on clinical efficacy, availability, feasibility of administering, drug interactions, and which variants are most prevalent in your neighborhood.

In December 2021, the FDA re-issued a warning that Ivermectin currently has insufficient evidence for treatment of COVID-19. Ivermectin is still under investigation in clinical trials, but currently the NIH cites a total of 9 clinical studies that show no improvement in symptoms, and no differences in mortality or hospital length of stay.

FDA Emergency Use Authorized Monoclonal Antibodies include: Bamlanivimab plus Etesevimab*; Bebtelovimab OR Casirivimab plus Imdevimab*, Sotrovimab*, Tixagevimab Plus Cilgavimab (* means paused due to reduced Omicron susceptibility).

For non-hospitalized patient, antiviral therapy is recommended (Paxlovid preferred over Remdesivir). If those are not available/feasible/clinically appropriate, use antiviral Molnupiravir or antibody Bebtelovimab.

Hospitalized patients are given Remdesivir as it needs to be administered with an IV over a period of three days.

Source(s):

  • NIH antiviral therapy summary recommendations
  • NIH antibody summary recommendations
  • FDA Warning on Ivermectin
  • NIH Ivermectin selected clinical data
  • FDA Paxlovid Emergency Use Authorization Healthcare Provider Fact Sheet
  • NIH COVID-19 Clinical Management summary