Should I take COVID-19 antiviral drugs?

WI am The Omicron variant is still circulating worldwide, and home tests for COVID-19 are becoming increasingly common, more and more people are testing positive for SARS-CoV-2. That made them wonder if there was anything they could do to cut the number of sick days and, more importantly, reduce their risk of becoming seriously ill. Here is the breakdown treatments available, who should use them and when.

Can anyone who tests positive for COVID-19 be treated with the drug?

Currently, COVID-19 therapy is not available to the vast majority of people who test positive. They are targeted at people with underlying health conditions, those who may not have had a strong immune response to the vaccine, or the elderly, all of whom are so susceptible to severe symptoms that they may require hospitalization. However, researchers are studying the risks and benefits of the therapies to see if expanding treatments to include more people who test positive is safe and effective.

How many drug therapies are available to treat COVID-19?

Drug-based treatments for COVID-19 basically fall into one of two categories: monoclonal antibodies or anti virus.

Monoclonal antibodies are compounds that mimic parts of immune cells that SARS-CoV-2 infects. With enough monoclonal antibodies floating around, the virus binds to these drugs instead of healthy cells, greatly reducing the number of healthy cells that end up infected and becoming the factory for many viruses. withdraw more.

There are currently four such therapies approved by the FDA:

  • Tixagevimab and cligavimab
  • Sotrovimab
  • Bamlanivimab and etesevimab
  • Casirivimab and imdevimab

Only the first-line therapy remained effective in protecting against the Omicron variant.

Antiviral drugs works by disrupting the virus’s use of healthy cells’ machinery to copy its genetic material and reproduce. In October 2020, the US Food and Drug Administration (FDA) approved the first COVID-19 antiviral drug, remdesivir, was manufactured by Gilead, after emergency use authorization for the drug in May 2020. This is an IV drug that can only be used in a hospital or infusion clinic.

In December 2021, FDA allow the first antiretroviral pill, Paxlovid, from Pfizer. Paxlovid is actually a combination of two drugs, one that stops SARS-CoV-2 from replicating and another that prevents the body from breaking down the old drug too quickly. Paxlovid is recommended for people at high risk of developing severe or life-threatening COVID-19 illness; Treat by taking three tablets twice a day, for five days.

Just one day after licensing Paxlovid, the FDA also second COVID-19 antiviral pill allowed, molnupiravir, from Merck. It works by introducing genetic mistakes during viral replication. As with Paxlovid, molnupiravir is for people who are susceptible to severe COVID-19 illness; The latter, however, requires taking four tablets twice a day, for five days.

How effective are antibody treatments?

Research to date shows that monoclonal antibodies can reduced risk of hospitalization and death up to 80% more than those who don’t take the drug.

The problem with these therapies, however, is that SARS-CoV-2 can easily mutate around them. The FDA has authorized four such therapies, but three of them were ineffective in protecting against the Omicron variant. The National Institutes of Health urges doctors to prescribe only one of the authorized therapies, Evusheld (a combination of tixagevimab and cilgavimab given as two injections), administered by AstraZeneca. In one learn published on April 20 in New England Journal of MedicineResearchers led by a team at AstraZeneca have found that the company’s two-drug combination reduces the risk of COVID-19 symptoms in vulnerable people by almost 77% compared with those who do not. use a placebo.

How effective are antiviral treatments?

Antiviral drugs are also good effective; Studies show that Paxlovid can reduce the risk of hospitalization by more than 90% among the most susceptible. Molnupiravir is much less effective in reducing the risk of hospitalization and death if taken a few days after symptoms appear, but much more effective if used earlier in the course of the disease, reducing that risk by 30 % to 50% in people taking the drug compared with people not using it.

When should I have these treatments?

Because of the way monoclonal and antiviral antibodies work, both need to be monitored very close to the time a person is infected, preferably even before they experience symptoms — and ideally less than five days after diagnosis or symptoms appear. The sooner the drugs enter the body, the stronger they are to overwhelm the SARS-CoV-2 virus before it can invade the immune system.

For people who never feel sick enough to need medication, medication may not be necessary. However, for people who become ill, but not immediately after infection, it can be more difficult to start one of these therapies at the right time, as they all require a doctor’s prescription. The Biden Administration’s Trials for Treatment program aims to streamline access to drugs, but it Not all proven effective yet.

And that’s all just for those most vulnerable to developing severe COVID-19. For most people who can recover from an infection without serious side effects, more studies are needed to assess the safety and effectiveness of antiviral treatments. , especially for new variants like Omicron.

Those ongoing studies are also looking at persistent COVID symptoms, to determine whether the longer-lasting effects of mild illness could have a negative impact on human health. If so, that would make a stronger argument for expanding populations that can be treated with COVID-19 therapy.

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