Current Effective Therapeutics in Management of COVID-19

Abstract

The current pandemic due to the SARS-CoV-2 virus has caused irreparable damage globally. High importance is placed on defining current therapeutics for Coronavirus Disease 2019 (COVID-19). In this review, we discuss the evidence from pivotal trials that led to the approval of effective therapeutics in the treatment and prevention of COVID-19. We categorize them as effective outpatient and inpatient management strategies The review also attempts to contextualize the efficacy of therapeutics to the emerging variants. Vaccines, which remain the most effective prevention against hospitalization and deaths is not included in this review.

Effectiveness of the available early therapies in reducing severe COVID-19 in non-hospitalized patients with solid tumors on active treatment

“…Their clinical effects were seen in unvaccinated patients, and the trials took place before the emergence of the Omicron variant. The real-world effectiveness of monoclonal antibodies and oral antiviral agents in patients with cancer with COVID-19 is largely uncharacterized ( 3 ). We conducted an ambispective cohort study of patients with solid tumors on active treatment to examine the effectiveness of these drugs in preventing the progression to severe COVID-19.…”

Efficacy and safety of oral antivirals in individuals aged 80 years or older with mild-to-moderate COVID-19: preliminary report from an Italian Prescriber Center

“…Currently molnupiravir and nirmatrelvir, represent a pivotal weapon in the early management of mild-to-moderate COVID-19 to prevent the progression to severe disease in high-risk subjects [4][5][6]. Their use has highlighted advantages on several aspects.…”

Outpatient anti-spike monoclonal antibody administration is associated with decreased morbidity and mortality among patients with cancer and COVID-19

“…We retrospectively studied patients with history or active cancer at Brown University-affiliated hospitals, diagnosed with SARS-CoV-2 infection between November 9, 2020 (date of Emergency Use Authorization [EUA] for the first mAb-bamlanivimab), and July 21, 2022. Patients were excluded if they met any of the following criteria: (1) < 18 years old; (2) received nirmatrelvir/ritonavir (Paxlovid®); were not eligible for mAbs under EUA, specifically: (3) hospitalized for COVID-19 at presentation, even if they received mAbs while inpatient; (4) had symptoms for more than 10 days; or (5) presented with high O 2 requirements due to COVID-19, compared to baseline [ 11 , 12 ]. Any patient eligible for mAbs under the EUA criteria was included in our study design, nonetheless, the choice to receive or not mAbs was multifactorial and dependent on: (1) the clinician’s judgment whether or not to preferentially hospitalize patients with cancer and COVID-19; (2) the on-site availability of mAbs; and (3) clinical choices made by, and the relationship between, the patient and the clinician [ 13 ].…”