Eligibility for COVID-19 Oral Antivirals

COVID-19 and Oral Antivirals: How to Define an Eligible Patient https://www.medscape.org/sites/advances/covid-19-antivirals?sso=true&uac=148436CN&src=mkmcmr_reeng_recap_mscpedu_activity Below are some key learning points to help reinforce the impact of this activity. ☑ COVID-19 remains an important health issue, with a significant number of COVID-19--related hospitalizations and deaths continuing to be reported and the number of positive cases as high or even higher than those reported for rhinovirus, influenza, and respiratory syncytial virus, depending on the season. ☑ Despite most people having a mild to moderate upper respiratory tract infection due to COVID-19, many people remain at high risk of developing severe or prolonged disease, including • Persons aged ≥ 65 years, persons with comorbidities (eg, obesity, diabetes, cardiovascular disease, chronic lung disease, chronic liver disease, chronic kidney disease), active cancers, trisomy 21, or other chronic diseases. • Patients at highest risk include solid organ transplant recipients, patients after anti-B cell antibody therapy, chimeric antigen receptor T-cell therapy recipients, patients under severe immunosuppression (eg, chemotherapy), patients with severe immunodeficiencies affecting antiviral immunity, and autologous or allogeneic stem cell transplant recipients before immunologic reconstitution. ☑ Based on the World Health Organization Living Guideline on Treatments for COVID-19, oral antivirals nirmatrelvir-ritonavir (strong recommendation) and molnupiravir (weak/conditional recommendation) are indicated for nonhospitalized patients who are at risk for severe outcomes from COVID-19. Remdesivir is another antiviral drug that is only available in intravenous formulation. ☑ The eligibility criteria for oral antivirals include evidence of symptoms of COVID-19, confirmation of SARS-CoV-2 infection by polymerase chain reaction or lateral flow test, and being part of one of the higher-risk groups. Depending on local guidance, the onset of symptoms and a positive test should be within 5 to 7 days of the start of treatment with oral antivirals. ☑ The importance of testing, personalization of risk assessments based on a patient’s medical history, acting quickly if antiviral treatment is appropriate, and communication strategies explaining that COVID-19 can lead to severe disease should be emphasized when treating at-risk patients to prevent serious outcomes.