Q and A with the experts: Treatment options for mild COVID-19

There are four treatment options available for mild cases of COVID-19. What are they, and how do they work?

Kelly Grindrod, a pharmacist and University of Waterloo professor, answers common questions about these medications.

What is “mild” COVID-19?

Mild COVID-19 means that you have tested positive for COVID-19 and have symptoms, but you are not sick enough to need extra oxygen. Symptoms of mild COVID-19 can include a cough, sore throat, headache, runny or stuffy nose, nausea, diarrhea, muscle aches, fever, low energy, and/or a change in taste or smell. Mild COVID-19 can quickly become more severe.

Are COVID-19 drugs recommended for me?

If you are at higher risk of hospitalization from COVID-19, treatment may be recommended for you. People at the highest risk include those who are not vaccinated or who are immunocompromised. Others at high risk include those who have received only one or two vaccine doses, are older, and/or have multiple chronic medical conditions. Treatments are not recommended for everyone with mild COVID-19. We do not know yet if people who have a lower risk of hospitalization from COVID-19 will benefit from these drugs. Talk to your doctor or healthcare provider who can help advise whether you would benefit from this medication.

What drugs can be used to treat mild COVID-19?

There are four drugs that may be recommended for you in the case of mild COVID-19. Health Canada has approved two prescription drugs that can be used for mild COVID-19.

1. Nirmatrelvir/Ritonavir (Paxlovid™) - an antiviral drug taken by mouth. It stops the COVID-19 virus from making copies of itself. 
2. Remdesivir (Veklury^Ⓡ) - an antiviral drug given intravenously. It stops the COVID-19 virus from making copies of itself.

There are two other drugs that have been available for years, but that may also be used for COVID-19.

1. Budesonide (Pulmicort^Ⓡ) - a common inhaled anti-inflammatory drug, often used to treat asthma or chronic obstructive pulmonary disease.
2. Fluvoxamine (Luvox^Ⓡ) - an antidepressant drug with anti-inflammatory effects taken by mouth.

Why are COVID-19 treatments recommended more strongly for people who have not been vaccinated yet?

People who have not been vaccinated yet are at higher risk of needing to be treated in hospital than most people who are up to date with COVID-19 vaccines. We do not know if these drugs will benefit most people who have had all recommended vaccines. Right now, the risks of side effects and drug interactions are greater than the known benefits of treatments for most people whose vaccines are up to date.

Do I need to have a positive COVID-19 test to get treatment?

See the full Q and A on the Waterloo News website.