COVID-19 infusion treatments deliver medications directly into the bloodstream to combat the SARS-CoV-2 virus. These therapies aim to reduce illness severity, shorten its duration, and prevent progression to severe disease requiring hospitalization. Infusions offer a targeted approach to managing the infection, especially for individuals at higher risk for complications.
How COVID-19 Infusions Work
COVID-19 infusion therapies introduce substances that either directly neutralize the virus or interfere with its ability to replicate. Monoclonal antibodies are laboratory-produced proteins that mimic the body’s natural antibodies. They target the spike protein on the SARS-CoV-2 virus, which the virus uses to enter human cells. When monoclonal antibodies bind to this spike protein, they block the virus from attaching to and infecting cells, reducing the viral load and preventing the infection from worsening.
Another class of infused medications consists of antiviral agents, such as remdesivir. These antivirals interfere with the virus’s replication process once it has entered the cells. Remdesivir, for instance, inhibits a viral enzyme called RNA-dependent RNA polymerase, essential for the virus to make copies of itself. By disrupting this process, antiviral infusions slow the virus’s spread, allowing the immune system more time to respond and limiting the infection’s impact.
Types of Infusion Therapies
Historically, several types of infusion therapies were used to treat COVID-19, including monoclonal antibodies and antivirals. In the early stages of the pandemic, various monoclonal antibody cocktails, such as bamlanivimab, casirivimab, and imdevimab, were authorized for emergency use. These treatments aimed to prevent hospitalizations in high-risk patients with mild to moderate symptoms.
However, as the SARS-CoV-2 virus evolved, many of these initial monoclonal antibody therapies became less effective against newer variants like Omicron and its subvariants. Consequently, their emergency use authorizations were deauthorized or restricted by regulatory bodies. Currently, the primary infused treatment is the antiviral medication remdesivir (Veklury), which has maintained effectiveness across different viral variants by targeting a conserved part of the viral replication process. Remdesivir is approved for use in both hospitalized and certain high-risk non-hospitalized patients.
Who is Eligible for Treatment
Eligibility for COVID-19 infusion treatment is based on the patient’s health status, symptom severity, and underlying risk factors. Candidates must have tested positive for COVID-19 and be experiencing mild to moderate symptoms. Patients should not be hospitalized due to COVID-19 or require new or increased supplemental oxygen, as these treatments are most effective early in the disease course.
A key criterion for eligibility is being at high risk for progression to severe COVID-19, hospitalization, or death. Risk factors include being 65 years or older, having a body mass index (BMI) over 25, and chronic medical conditions such as kidney disease, diabetes, cardiovascular disease, or chronic lung disease. Immunosuppressed individuals, pregnant patients, and those with neurodevelopmental disorders are also considered high-risk. Treatments are most beneficial when administered as soon as possible after diagnosis and within 5 to 10 days of symptom onset.
The Infusion Experience and What Comes Next
Receiving a COVID-19 infusion occurs in an outpatient clinic or hospital setting. Medical staff prepare the patient for the intravenous (IV) infusion, which involves inserting a small needle into a vein, usually in the arm. The infusion itself can take approximately 30 minutes to two hours, depending on the specific medication.
During and immediately after the infusion, healthcare providers closely monitor the patient for any potential reactions. While serious side effects are uncommon, patients might experience mild reactions such as flu-like symptoms, nausea, headache, dizziness, or reactions at the injection site. Rare, more significant reactions, including allergic responses, breathing difficulties, or changes in heart rate, require immediate medical attention. Following treatment, patients are observed for about an hour to ensure stability before discharge. Individuals should continue following isolation guidelines and monitor their symptoms, contacting their healthcare provider if their condition worsens.