When a person is infected with the virus that causes COVID-19, certain medications can help lessen the severity or duration of the illness. These treatments are distinct from vaccines, which are administered for prevention before an infection occurs. The specific course of treatment a patient receives depends on several factors, including the gravity of their symptoms and their individual risk for developing a more serious case of the disease.
Prescription Antiviral Medications
Antiviral medications function by inhibiting the virus’s ability to replicate within the body. For individuals with mild to moderate COVID-19 who are not hospitalized but have a higher risk of their illness becoming severe, doctors may prescribe these drugs. Starting these treatments soon after symptoms appear is important for their effectiveness. The goal is to reduce the viral load, lessening the infection’s impact and preventing progression to a more serious stage.
One of the most commonly prescribed treatments is an oral antiviral medication that combines nirmatrelvir and ritonavir, known by the brand name Paxlovid. Nirmatrelvir works by blocking a specific enzyme the virus needs to replicate. The second drug, ritonavir, is included to slow down the breakdown of nirmatrelvir in the body, which helps maintain a higher concentration of the active drug for a longer period. This medication is taken as pills at home.
Another primary antiviral medication is Remdesivir, which is administered intravenously (IV) and is also used for non-hospitalized patients at high risk of severe disease. Remdesivir functions as a nucleotide prodrug; once inside cells, it is converted into a form that interferes with the virus’s RNA polymerase, an enzyme necessary for viral replication. For outpatients, this therapy is given over three consecutive days.
Eligibility for these antiviral treatments is focused on individuals considered to be at high risk for progressing to severe COVID-19. This category often includes older adults and people of any age with certain underlying medical conditions. Chronic lung disease, heart conditions, diabetes, obesity, and immunocompromising conditions are common factors that place a person at higher risk.
Hospital Treatments for Severe Illness
When COVID-19 progresses to a severe stage requiring hospitalization, the focus of treatment often shifts. In these cases, a significant danger arises from the body’s own immune system, which can become overactive and trigger a massive inflammatory response sometimes referred to as a “cytokine storm.” This excessive inflammation can lead to widespread damage to organs, particularly the lungs.
To counter this inflammatory response, corticosteroids are a primary line of defense. Dexamethasone is a widely used corticosteroid that has been shown to reduce mortality in hospitalized patients who require supplemental oxygen or mechanical ventilation.
In addition to corticosteroids, other drugs known as immunomodulators may be used to further regulate the immune response. Medications like baricitinib or tocilizumab target specific components of the inflammatory pathway. Baricitinib works by interfering with cellular signaling that leads to inflammation, while tocilizumab blocks a receptor for a specific inflammatory protein. These treatments are often administered to patients who need increasing levels of respiratory support and are sometimes used in combination with supportive care like oxygen therapy.
Managing Symptoms at Home
For the majority of individuals who contract COVID-19, the illness is mild and does not necessitate prescription medications or hospital care. Symptoms can be managed effectively at home with over-the-counter (OTC) products designed to provide comfort and relief. These remedies help alleviate the discomfort associated with the infection while the body’s immune system works to fight off the virus.
Common symptoms like fever, body aches, and headaches can often be managed with pain relievers and fever reducers like acetaminophen or ibuprofen. Cough suppressants containing dextromethorphan can reduce the urge to cough, while expectorants with guaifenesin can help loosen mucus, making coughs more productive.
Nasal congestion and a runny nose can be addressed with saline nasal sprays, which help to moisten nasal passages and clear out congestion without medication. For more significant stuffiness, oral decongestants or decongestant nasal sprays may provide short-term relief. It is important to read all product labels carefully and consult with a doctor or pharmacist before taking any new medication, especially for those with pre-existing health conditions or who are taking other drugs.
Disproven and Unrecommended Treatments
Throughout the pandemic, various medications have been suggested as potential treatments for COVID-19, leading to widespread misinformation. Two drugs that gained significant attention are ivermectin, an anti-parasitic agent, and hydroxychloroquine, a drug used for malaria and certain autoimmune conditions. Despite initial interest, large-scale, controlled scientific studies have since been conducted on these substances.
The results from major clinical trials have demonstrated that neither ivermectin nor hydroxychloroquine provides a benefit in treating COVID-19. Consequently, prominent health organizations, including the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH), do not recommend their use for this purpose.
These medications are not without risks and can cause significant side effects. Claims that these drugs are viable treatments are considered false by the medical and scientific communities. It is important to rely on treatments that have been properly vetted and authorized by regulatory bodies.