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.
- Sotrovimab is the only monoclonal antibody with effectiveness against the omicron variant. Click here to read this referencing article.
- 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)
- Cook Children's is currently out of Sotrovimab.
- 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:
- Patients have to be unvaccinated, or under vaccinated, or not believed to be able to respond to the vaccine.
- Patients must be actually infected with the virus. We would not use this for post exposure prophylaxis now.
- After the first two criteria are met, cases would be individualized by calling the Infectious Diseases doctor on-call.
- 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) | Sotrovimab | Remdesivir | Molnupiravir | |
Efficacy | Relative Risk Reduction 88% | Relative Risk Reduction 85% | Relative Risk Reduction 87% | Relative Risk Reduction 30% |
Pros | 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 |
Cons | Drug Drug interactions | Requires IV infusion followed by 1 hour obs | Requires IV infusion on 3 separate days | Low efficacy Concerns for mutagenicity Not recommended in pregnancy/children |