COVID-19 Testing and Treatment At-a-Glance Test for COVID-19 5 DAYS after exposure. Patients with COVID-19 should ISOLATE FOR 5 DAYS, followed by 5 days of mask wearing (assuming symptoms are improving and fever has resolved). Patients with mild or moderate COVID-19 who are at high risk for progression to severe COVID-19 through either older age or comorbidities may be eligible for treatment. Comorbidities include immunocompromising conditions or treatments, obesity, diabetes, cardiovascular disease, cancer, chronic kidney disease, chronic lung diseases, chronic liver diseases, and transplantation. Nirmatrelvir + ritonavir (Paxlovid™) is the preferred treatment, with remdesivir (Veklury®) a second choice. If neither is available or appropriate, bebtelovimab or molnupiravir (Lagevrio™) may be used.
Therapy
Indication
Dosing Regimen
Nirmatrelvir + ritonavir (RTV) (Paxlovid™)
Treatment for mild to moderate COVID-19 in patients aged ≥12 years weighing ≥40 kg who are at high risk for COVID-19 progression.
• Given within 5 days of symptom onset • eGFR ≥60 mL/min: Nirmatrelvir 300 mg + RTV 100 mg orally twice daily for 5 days • eGFR ≥30 and <60 mL/min: Nirmatrelvir 150 mg + RTV 100 mg orally twice daily for 5 days • eGFR <30 mL/min: Not recommended • Child-Pugh Class C: Not recommended
Remdesivira (Veklury®)
Treatment for mild to moderate COVID-19 in patients aged ≥28 days weighing ≥3 kg who are at high risk for COVID-19 progression
• Given within 7 days of symptom onset • Patients ≥40 kg: 200 mg IV on day 1, followed by 100 mg IV once daily on days 2 and 3 • Patients ≥3 kg to <40 kg: 5 mg/kg IV on day 1 followed by 2.5 mg/kg on days 2 and 3 • Each infusion should be administered over 30-120 minutes • Patients should be observed for ≥1 hour after infusion as clinically appropriate • eGFR <30 mL/min: Not recommended
Bebtelovimab
Treatment for mild to moderate COVID-19 in patients aged >12 years weighing >40 kg who are at high risk for COVID-19 progression, and only if alternative therapies are not available or appropriate
• Given within 7 days of symptom onset • 175 mg as a single IV injection, administered over >30 seconds • Patients should be observed for >1 hour after injection
Molnupiravir (Lagevrio™)
Treatment for mild to moderate COVID-19 in nonpregnant adults who are at high risk for COVID-19 progression, and only if the above therapies are not available or appropriate
• Given within 5 days of symptom onset • 800 mg orally twice daily for 5 days
Also indicated for patients hospitalized with COVID-19.
a
A nationwide Test to Treat initiative has established thousands of centers for people to be tested, receive a prescription for an oral antiviral, and have the prescription filled all at 1 location. Locations can be identified at https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com/. www.ExchangeCME.com/Covid19Resources