Treatment for COVID-19 when symptoms are still quite mild can greatly reduce risk of developing severe COVID-19. These treatments help you get better faster and avoid needing to be hospitalized. These therapies are available at Mass General Brigham and at Massachusetts Department of Public Health treatment sites.

Patients at increased risk of severe COVID-19 are eligible. About 40% of all Mass General Brigham patients have increased risk conditions and are eligible.

Please see below for additional details regarding outpatient treatment options for COVID-19.

Oral antiviral treatments for COVID-19 - Paxlovid

Oral antiviral treatments are taken by mouth to treat mild to moderate symptoms of COVID-19. The Food and Drug Administration (FDA) has issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets). This medication slows down COVID-19’s ability to replicate.

Remdesivir

Remdesivir is an FDA-approved medicine that interferes how the COVID-19 virus replicates. It can help people with COVID-19 recover faster and reduce the chances of developing severe COVID-19. It can also be used to treat patients in the hospital, but here we are focusing its use to prevent being hospitalized. The NIH COVID-19 Treatment Guidelines provide information about this drug.

  • How is Remdesivir given?

    Remdesivir is given by 3 daily intravenous (IV) infusions. It’s not a pill.

  • When should Remdesivir be given?

    Remdesivir works best when given early at least within the first seven days of symptoms. If you are already improving, treatment is probably not necessary.

  • Can I get Remdesivir treatment if I’ve been vaccinated and then got COVID-19?

    You can get Remdesivir if you have been vaccinated for COVID-19. You must meet eligibility criteria.

  • If I have not been vaccinated, can I get Remdesivir therapy?

    You can get Remdesivir if you have not been vaccinated. You must meet eligibility criteria.

  • How good is Remdesivir therapy?

    Remdesivir has been shown to reduce the chance of hospitalization by 82% and help people improve faster.

  • Who is eligible to get this therapy?

    Remdesivir is available for patients ages 12 years and older who:

    • Weigh at least 40kg AND
    • Have COVID-19 confirmed by either antigen or PCR testing AND
    • Have symptomatic COVID-19 AND
    • Are within 7 days of the start of symptoms AND
    • Have a health condition that makes them more likely to have severe COVID-19 infection.
  • Is Remdesivir expensive for me?

    It depends. Remdesivir is no longer provided for free by the US Government and your insurance will be billed for the expense. You may need to pay for co-payments or deductibles depending on your insurance. Remdesivir can be obtained for free at Massachusetts Department of Public Health treatment sites.

  • How do I get Remdesivir if I have COVID-19?

    If you think you might be eligible, please contact your primary care provider or specialist. They can refer you for treatment. Please note that due to the limited supply, not all patients referred will be able to receive the treatment.

    Do not go to urgent care or the emergency room or for any of these therapies. They are not available at those locations. There are specific clinics designed to give this therapy.

  • I have been referred for this therapy, what happens next?

    We have limited quantities of Remdesivir available. If you are able to get the therapy, we will contact you with information and instructions. For patients who are on Patient Gateway, we will send a Patient Gateway message if we determine that we cannot offer treatment. If you are not enrolled in Patient Gateway, you can sign up here.

Monoclonal antibodies (mAb) - Bebtelovimab

The Federal Drug Administration (FDA) has issued emergency use authorization (EUA) for several investigational monoclonal antibodies. These antibodies can help the immune system respond to fight the virus. The NIH COVID-19 Treatment Guidelines provide information about these drugs.

  • What is Bebtelovimab?

    Bebtelovimab is the only monoclonal antibody effective against the COVID-19 BA.2 Omicron sub-variant. It is used for patients who have symptomatic COVID-19. Bebtelovimab is not available for patients who have been exposed to COVID-19 but have not contracted the virus.

  • How is Bebtelovimab given?

    Bebtelovimab is given by IV infusion (not a pill).

  • When should Bebtelovimab be given?

    Monoclonal antibody therapy is best when given within the first few days of symptoms. If your symptoms are already improving, treatment is probably not necessary.

  • Can I get monoclonal antibody treatment if I’ve been vaccinated and then got COVID?

    You may be able to get monoclonal antibody therapy if you have been vaccinated for COVID-19. You must meet eligibility criteria.

  • If I have not been vaccinated, can I get monoclonal antibody therapy?

    You may get this therapy if you have not been vaccinated. You must meet eligibility criteria.

  • How well does monoclonal antibody therapy work?

    Monoclonal antibody therapy has been shown to decrease the risk of hospitalization in patients who are at high risk for severe COVID-19 when given early in symptomatic COVID-19 infection. Trials have found a reduction in the risk of hospitalization of up to 70% to 90% with other monoclonal therapies compared with no therapy. There is no data available yet on the impact of bebtelovimab on risk of hospitalization or death. However, laboratory testing showed that bebtelovimab is effective against both the omicron variant and the BA.2 omicron subvariant.

  • Who is eligible to get this therapy?

    Bebtelovimab therapy is available for patients who are ages 12 years and older and:

    • Weigh at least 40 kilograms (a little over 88 pounds) AND
    • Have COVID-19 confirmed by either antigen or PCR testing AND
    • Have symptomatic COVID-19 AND
    • Are within 7 days of the start of symptoms AND
    • Have a health condition that makes them more likely to experience severe COVID-19 infection.
  • Is Betelovimab expensive for me?

    It depends. Bebtelovimab is provided for free by the US Government but the cost of the infusion may be billed to your insurance. You may need to pay for co-payments or deductibles depending on your insurance. Bebtelovimab can be obtained for free at Massachusetts Department of Public Health treatment sites.

  • How do I get Bebtelovimab if I have COVID-19?

    These therapies are available at Mass General Brigham and at Massachusetts Department of Public Health treatment sites. Both locations are excellent options for treatment. If you think you might be eligible for treatment, please contact your primary care provider or specialist. They can refer you for treatment.

    Do not go to urgent care or the emergency room for any of these therapies. They are not available at those locations. There are specific clinics designed to give this therapy.

  • I have been referred for this therapy. What happens next?

    If you are able to get the therapy, we will contact you with information and instructions. For patients who are on Patient Gateway, we will send a Patient Gateway message if we determine that we cannot offer treatment. If you are not enrolled in Patient Gateway, you can sign up here.

    If your provider has referred you to Department of Public Health treatment sites, you will receive a call if you can be accommodated. They do not currently contact patients or Mass General Brigham if you cannot be treated.

Evusheld

Tixagevimab/Cilgavimab (Evusheld) is an antibody cocktail used to prevent COVID-19 in people who cannot be adequately protected by vaccination. The Federal Drug Administration (FDA) has issued emergency use authorization (EUA) for Evusheld. This medication contains monoclonal antibodies that can help the immune system respond to fight the virus. It is used to reduce the risk of COVID-19 infection in patients who have a weakened immune system. It is not a substitute for vaccination. It is also not used to treat COVID-19 infection. The NIH COVID-19 Treatment Guidelines provide information about this drug.

  • How is Evusheld given?

    Evusheld is given as an injection. It is not a pill.

  • Who is eligible to get this therapy?

    Evusheld is available for patients ages 12 years and older who:

    • Weigh at least 40kg (a little over 88 pounds) AND
    • Do not have an active COVID-19 infection or a recent exposure AND
    • Are up to date on COVID-19 vaccines (unless there is a medical reason against vaccination, such as severe allergies) AND
    • Have a weakened immune system and therefore, may have an inadequate immune response to COVID-19 vaccination
  • How often does Evusheld need to be given?

    Currently repeat dose is only recommended if you previously received a lower dose (150mg of each antibody) of Evusheld. If you received Evusheld before February 28, you received this lower dose. You should receive an additional dose to increase the effectiveness against the Omicron subvariants. If you think you may have received the lower dose of Evusheld and haven’t yet received an additional dose, please contact your provider.

    The FDA is monitoring the duration of protection and is expected to release recommendations about second full doses sometime before summer.

  • Can I get Evusheld if I’ve been vaccinated?

    Yes. You must be fully vaccinated prior to receiving Evusheld. Of note, Evusheld should be administered at least 2 weeks after vaccination.

  • Can I get Evusheld if I have not been vaccinated?

    No. Evusheld is not a substitute for COVID-19 vaccination. It will not be used in unvaccinated people who are expected to have an adequate immune response to vaccination. The only exception is if there is a medical reason against vaccination (for example: history of severe allergic reaction to the COVID-19 vaccine).

  • How well does Evusheld work?

    It is not really known how well Evusheld works in people with a weakened immune system. Evusheld has been shown to reduce the chance of infection by 77% in one study in people with normal immune systems. Evusheld is expected to provide protection against the Omicron BA.2 subvariant.

  • Do I need more than one Evusheld dose?

    It is not yet known how often you will need to get subsequent doses of Evusheld. The FDA is still determining the schedule but likely will be every 3 to 6 months. If you received Evusheld before February 28, 2022, you may need to get an additional dose to provide better protection against the Omicron variant.

  • How do I get Evusheld therapy?

    If you think you might be eligible, please contact your primary care provider or specialist. They can refer you to receive Evusheld.

    Please note that Evusheld is not used for COVID-19 treatment. It is used to reduce the risk of COVID-19 infection in patients with a weakened immune system.

    Do not go to urgent care or the emergency room or urgent care for Evusheld therapy; It is not available at those locations. There are specific clinics designed to give this therapy.

  • I have been referred for this therapy, what happens next?

    If you can get the therapy, we will contact you with information and instructions. For patients who are on Patient Gateway, we will send a Patient Gateway message if we determine that we cannot offer treatment.

Who is eligible for these treatments?

To receive outpatient treatments for COVID-19, you must have COVID-19 confirmed by either antigen or PCR testing. You must also have a health condition that makes you more likely to experience severe COVID-19 infection. Patients are prioritized for the available treatments based on their risk of severe COVID-19.

High-risk conditions for severe COVID-19 include undergoing treatment for cancer, currently taking medications for transplant, or immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may predispose you to worse symptoms from COVID-19 or influenza. Learn more about predisposing health conditions from the CDC


Updated 6/6/2022