Yesterday marked an important milestone in the fight against COVID-19, as the FDA granted two COVID-19 oral antiviral treatments Emergency use Authorization: Paxlovid (Pfizer) and Molnupiravir (Merck). Both antiviral treatments work by interfering with the virus’ ability to reproduce and replicate within the body, but in slightly different ways. Paxlovid treats the virus by targeting its main component (protease), which restricts its ability to replicate. In contrast, Molnupiravir works by ‘sabotaging’ the coronavirus’ genetic code. Both Paxlovid and Molnupiravir are treatments for people who both recently test positive and show symptoms of COVID-19: they work to contain the severity of the illness and to reverse the spread of the virus. They are not authorized for use by people who haven’t tested positive because Paxlovid and Molnupiravir can only work when the virus is present in the body. Paxlovid is the preferred treatment: people who took it showed an 88% reduction in hospitalization and death, compared to 30% with Molnupiravir.
We are also learning more about which monoclonal antibody treatments are effective against the Omicron variant. So far, Sotromivab is the only monoclonal antibody treatment which has activity against Omicron. Its supply is extremely limited. Sotromivab treatment will be prioritized for moderately and severely immunocompromised people, regardless of age and vaccine status. It will also be prioritized for those 65 and up, who are not fully vaccinated and who also have an additional risk factor for severe illness (such as chronic kidney, heart, or lung disease, obesity, neurogenetic issues, and severe asthma, to name a few).
Specialist in internal medicine and primary care.