15:31 PM

COVID-19 Treatment Information (Updated January 2022)

All treatments for COVID-19 are currently in very limited supply or unavailable.  Accordingly, treatment is being reserved for the highest-risk patients. 

 Monoclonal Antibody:

Key points to remember: as of this writing, supply is critical and may have reached zero.

  1. Sotrovimab is the only monoclonal antibody with effectiveness against the omicron variant. Click here to read this referencing article
  2. They are now only using Sotrovimab at the regional infusion center. However, currently the infusion center is out of antibody. If it becomes available again, we can still refer patients via the website : New Order (stateoftexasinfusionhotline.com)
  3. Cook Children's is currently out of  Sotrovimab.
  4. Please do not send patients to the Cook Children's Emergency Department for this, without speaking to the Infectious Diseases physician on-call. 

Criteria for using Sotrovimab:

  1. Patients have to be unvaccinated, or under vaccinated, or not believed to be able to respond to the vaccine.
  2. Patients must be actually infected with the virus. We would not use this for post exposure prophylaxis now. 
  3. After the first two criteria are met, cases would be individualized by calling the Infectious Diseases doctor on-call.
  4. The Infectious Diseases team will review logistics of Remdesivir in outpatients after we run out of Sotrovimab. Hopefully we won't have to.

NIH risk stratification is being used by the infusion center, when they do have Sotrovimab available.  You can call the infusion center to check availability.  1.800.742.5990

There are other treatments that may be available, or hopefully, become more available.

 Nirmatrelvir/ritonavir (Paxlovid)SotrovimabRemdesivirMolnupiravir
EfficacyRelative Risk Reduction 88%Relative Risk Reduction 85%Relative Risk Reduction 87%Relative Risk Reduction 30%

Highly efficacious

Oral regimen

Ritonavir safe in pregnancy

Highly efficacious

Monoclonal Ab typically safe in pregnancy

Few/no drug interactions

Highly efficacious

Studied in pregnancy

Few/no drug interactions

Oral regimen

Not anticipated to have drug interactions

ConsDrug Drug interactionsRequires IV infusion followed by 1 hour obsRequires IV infusion on 3 separate days

Low efficacy

Concerns for mutagenicity

Not recommended in pregnancy/children