Clinical Updates On COVID-19 Treatments and Vaccines

By now, after a few years of COVID-19 disease and virus management, many people in the United States have some sort of protection or immunity against the virus. This is due to mass vaccination, encountering previous infection, or both. The availability of tests and treatment options for these patients has also helped many diagnose the virus faster and be able to act before the illness can become more severe. Such actions have also helped reduce hospitalizations and deaths because of COVID-19.¹

Even with the current available treatment options, it is important to recognize the importance of masking, particularly for those with immunocompromised conditions and lowered immunity due to other comorbidities. Higher risk factors could also include age, lack of access to vaccination, and serious previous infections.¹

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Weekly new hospital admissions rates due to COVID-19 went from about 150,000 in January 2022 to about 15,722 in October 2023. The numbers may still be high, especially going into the flu and winter season, but there has been a huge reduction and improvement in reducing the hospitalizations since 2022.² Weekly deaths because of COVID-19 have been reduced from 24,845 in January 2021 to about 1369 September 2023.²

COVID-19 Treatment Options

There are now a number of treatment options available in the United States. Some of these options include the use of the antiviral nirmatrelvir/ritonavir (Paxlovid; Pfizer), which can be used for adults and children ages 12 years and older. This oral medication is taken at home. Another at-home, oral option is molnupiravir (Lagevrio; Merck), an antiviral agent that can be used in adults when initiated within 5 days of symptom onset. Remdesivir (Veklury; Gilead) is an inpatient treatment option used in adults and children and recommended to start within 7 days of symptoms onset. This medication is given intravenously as infusion at a health care facility for 3 consecutive days or more, if needed.³

Other authorized treatments for COVID-19 include tocilizumab (Actemra; Genentech) for hospitalized patients and baricitinib (Olumiant; Lilly), approved for hospitalized adults, especially needing oxygen.⁴

Immune modulators have also been used to activate and suppress the immune function for patients impacted by COVID-19. These include anakinra (Kineret; Sobi) for hospitalized pediatric ages 2 to less than 18 years of age who are receiving systemic corticosteroids and may require oxygen and mechanical ventilation. The investigational drug vilobelimab (Gohibic; Ementals), used for hospitalized patients, is another option to be initiated within 48 hours of receiving invasive mechanical ventilation.⁴

Some of these treatment options may have adverse effects or drug-drug interactions, just like other medications, and patients should be educated about potential symptoms or concerns.

Vaccines

There are currently a few options available to all patients in the United States. Depending on the location of the clinics and pharmacies, 1 or more of these vaccines may be available. Approved or authorized COVID-19 vaccines include Spikevax (Moderna), Comirnaty (Pfizer), Jcovden (Janssen), and COVID-19 Vaccine, Adjuvanted from Novavax.⁵

There are many other COVID-19 vaccines in clinical trials at this time. Patients should be encouraged to stay up-to-date on vaccinations, particularly those at higher risk of developing severe COVID-19.

Lastly, besides the treatment options mentioned above, as well as the vaccines available, protection tools such as masks and hand washing are effective tools to combat the spread of COVID-19, as well as other viruses circulating during the colder months. As we continue to combat this virus, with many more treatment options on the horizon, disease control will only become easier and more effective, if everyone participates.

References

1. COVID-19 by County. CDC. Updated May 11, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html

2. COVID Data Tracker. CDC. November 10, 2023. https://covid.cdc.gov/covid-data-tracker/#trends_weeklyhospitaladmissions_weeklyhospitaladmissions100k_00

3. COVID-19 Treatments and Medications. CDC. Updated October 4, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

4. Coronavirus (COVID-19) Drugs. FDA. Updated May 25, 2023. Accessed November 10, 2023. https://www.fda.gov/drugs/emergency-preparedness-drugs/coronavirus-covid-19-drugs

5. Stay Up to Date with COVID-19 Vaccines. CDC. Updated November 8, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html