Practicing Medicine COVID-19 Toolkit COVID-19 Treatment

COVID-19 Treatment

changing landscape

Review the latest recommendations & updates for treating COVID-19

The National Institutes of Health currently recognizes three primary antivirals to mitigate severe disease progression of COVID-19.

Last updated: October 2023

As the variants of the SARS-CoV-2 virus emerge, so too have treatment approaches and prevention measures. Over the past years, the rapid onset of the coronavirus disease (COVID-19) resulting from SARS-CoV-2 infection, has brought to light the need for quick responses and close surveillance of the virome to mitigate undesired health consequences among the population, specifically for those immunocompromised or who have comorbidities. Many of the initial practices used to treat COVID-19 are no longer effective with the emergence of variants. Current treatment protocols must be constantly assessed with the changing viral landscape.

The National Institutes of Health (NIH) recommends that all non-hospitalized adults with COVID-19 be offered symptom management. Today, antiviral treatment is the most effective method to mitigate mild to moderate COVID-19 variants in non-hospitalized patients.

The NIH recognizes three primary antivirals for patients who are at high risk of progressing to severe disease progression of COVID-19:

  • Ritonavir-boosted nirmatrelvir (Paxlovid)
  • Remdesivir (Veklury)
  • Molnupirarvir (Lagevrio) – While having a lower efficacy rate, molnupirarvir is a ribonucleoside shown to have antiviral activity and can be used as an alternative therapy

Timing plays a crucial role in each of these treatment options, as supported by extensive research studies. The NIH recommends initiating antiviral treatment within specific timeframes and routes.

Drug Initiation of Treatment Route Duration of Treatment
Ritonavir-boosted nirmatrelvir Within 5 days of symptom onset Oral 5 days
Remdesivir Within 7 days of symptom onset IV 3 days
Molnupirarvir Within 5 days of symptom onset Oral 5 days


Recognizing the potential for side effects and drug interaction, it is imperative for patients to consult and collaborate with their primary health care provider when considering these treatment options. A valuable tool in this regard is a drug interaction checker developed by The University of Liverpool to identify potential drug interaction complications during the COVID-19 treatment.

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