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COVID-19 Outpatient Treatment

Outpatient Treatment and therapies for COVID-19 can greatly reduce the risk of developing severe COVID-19.

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 can benefit. Patients with multiple risk conditions are strongly encouraged ask about treatment.

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.

It is used for patients who are symptomatic from COVID-19. It is not available for patients who have been exposed to COVID-19, but have not contracted the virus.

Paxlovid is an oral pill. It is available by prescription only.

Paxlovid must be given within 5 days of the start of symptoms, but it works best if taken earlier.

Yes. The oral antiviral treatment is available for vaccinated and not-yet-vaccinated patients.

Yes. The antiviral treatment could help you, too.

Researchers at Mass General Brigham and other hospitals have found that Paxlovid reduces chances of being hospitalized or dying from COVID-19 by 45% to 80%.

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

  • 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 5 days of the start of symptoms AND
  • Have a health condition that makes them more likely to experience severe COVID-19 infection.

Paxlovid can interact with other medications. Please let your care team know all the medications and supplements you are taking.

Paxlovid should not be used without specific discussion with your care team if you:

  • Have had a transplant and must take tacrolimus, cyclosporine, everolimus, or sirolimus
  • Have severe kidney or liver disease
  • Require certain anticoagulant medications (clopidogrel, rivaroxaban, or others)
  • Take many chemotherapy medications
  • Take St. John’s wort

There are other equally effective options for patients who have COVID-19 who cannot take Paxlovid. Contact your care team to understand what your best option might be.

No. Paxlovid has been provided free by the US Government and you can receive it no cost.

If you think you might be eligible for treatment, please contact your primary care or specialty care team. They can refer you for treatment.

For Massachusetts residents, there is also a free telehealth program to get oral Paxlovid treatment. This is offered through the Department of Public Health. You can get started on their website. Hours are 8 a.m. to 10 p.m. daily. Their services are available in English, Spanish, Haitian Creole, and Portuguese. Find out more information about program eligibility and Paxlovid on the mass.gov website.

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.

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

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.

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

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

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

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

  • Weigh at least 40 kg 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.

Not usually. It is available for free (no copay, deductible) for insured patients in Massachusetts. If you do not have insurance or your insurance is from outside of Massachusetts you may need to pay for co-payments or deductibles depending on your insurance. Remdesivir can be obtained for free regardless of insurance status at Massachusetts Department of Public Health treatment sites.

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.

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.

Monoclonal antibodies (mAb)

The Federal Drug Administration (FDA) issued emergency use authorization (EUA) for several investigational monoclonal antibodies. Monoclonal antibodies were previously used to help fight the virus. However, the Omicron subvariants in our region are not effectively treated by any of the available monoclonal antibodies. The NIH COVID-19 Treatment Guidelines provide information about these drugs.

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) issued emergency use authorization (EUA) for Evusheld. This medication contains monoclonal antibodies that can help the immune system respond to fight the virus. Evusheld was used to help fight the virus. However, Evusheld is not effective in preventing infection from many of the Omicron subvariants in our region. Evusheld may not meaningfully reduce risk while this subvariants are present.

The NIH COVID-19 Treatment Guidelines provide information about this drug.

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 11/16/2022