Therapeutics

There are no medicines that can cure COVID-19 infection. However, there are treatments that can benefit people who have serious symptoms. The medicines listed below have been recommended by the World Health Organization (WHO) and the United States National Institutes of Health (US NIH). This list will be revised as global treatment guidelines are updated.

Systemic corticosteroids are steroid hormones. They have an anti-inflammatory effect and are given orally or by injection.

Around 50 countries have the medicine either approved or for emergency use authorization for the treatment of COVID-19. Remdesivir was also another medicine that was studied in the Solidarity Trial, which was led by the World Health Organization (WHO).

The RECOVERY (Randomized Evaluation of COVID-19 Therapy) trial found that death from COVID-19 was lower among patients who received dexamethasone than those who received the standard of care without dexamethasone. In addition, the WHO and other researchers conducted a meta-analysis (which is a review of multiple studies) on the use of corticosteroid therapy for COVID-19 and found that these medicines improved survival of those with severe COVID-19 disease.

Additional information on the use of dexamethasone and other corticosteroids is available in the WHO and the US NIH COVID-19 treatment guidelines.

Remdesivir is an antiviral drug that inhibits the replication of a broad range of viruses.

The WHO does not recommend the use of remdesivir in hospitalized patients with COVID-19, regardless of disease severity. This recommendation was mainly based on the results of the SOLIDARITY trial, which was one of the largest randomized clinical trials to study COVID-19 treatments. Updated information on the use of remdesivir is available in the WHO guidelines.

However, the US NIH does recommend the use of remdesivir among hospitalized patients who require supplemental oxygen. Additional information is available in their guidelines.

IL-6 receptor blockers are a class of medicines that suppress parts of the immune system’s response to COVID-19, which if over activated, can be harmful to the patient.

The WHO and the US NIH have recommended the use of IL-6 receptor blockers tocilizumab or sarilumab for patients with severe or critical COVID-19 infection.

The WHO’s recommendation was based on results from the RECOVERY and the REMAP-CAP trials.

Additional information on the use of IL-6 receptor blockers is available in the WHO and the US NIH COVID-19 treatment guidelines.

A monoclonal antibody is an antibody made by cloning a unique white blood cell. Antibodies are proteins produced by a specific type of white blood cell, and are involved in protecting the body from bacteria, viruses, and other infectious diseases.

The WHO recommends treatment of COVID-19 with casirivimab and imdevimab among patients who are at highest risk of hospitalization or who are seronegative (without evidence of antibodies against COVID-19).

The US NIH also recommends either a combination of bamlanivimab and etesevimab, or of casirivimab and imdevimab for COVID-19 patients with mild to moderate disease. This is based on studies showing that these monoclonal antibody combinations have the potential to benefit non-hospitalized patients with mild to moderate COVID-19 who are at high risk for disease progression, or in an early stage of infection.

Additional information on the use of monoclonal antibodies is available in the WHO and US NIH COVID-19 treatment guidelines.

Barcitinib is what is called a “janus kinas inhibitor,” or JAK inhibitor. The WHO has recommended its use for treatment of severe or critical COVID-19, as an alternative to interleukin-6 (IL-6) receptor blockers. Barcitinib should be administered in combination with corticosteroids.

Additional information on the use of barticinib is available in the WHO COVID-19 treatment guidelines.

Sotrovimab is a neutralizing monoclonal antibody. The WHO has recommended that it can be used for treatment of individuals at highest risk of hospitalization due to COVID-19 infection, in order to prevent hospitalization.

Additional information on the use of sotrovimab is available in the WHO COVID-19 treatment guidelines.

Molnupiravir is an antiviral medication that inhibits the replication of certain RNA viruses.

The WHO has recommended that it can be used for the treatment of individuals with COVID-19 at highest risk of hospitalization. This medication should not be given to pregnant and breastfeeding women, and children.

Additional information on the use of molnupiravir is available in the WHO’s COVID-19 treatment guidelines.

Nirmatrelvir/ritonavir is a co-packaged antiviral oral medication used to treat COVID-19.

It is recommended strongly by WHO for those with non-severe COVID-19 who are at highest risk of subsequently developing severe disease and being hospitalized. This may include those who are unvaccinated, older, or immunosuppressed.

It should be administered as soon as possible after onset of symptoms, and ideally within 5 days.

It should not be used by pregnant women, children, or those with potentially serious drug interactions.

Additional information on the use of nirmatrelvir/ritonavir is available in the WHO COVID-19 treatment guidelines.