The Prescribe Right Pharmaceutical Pipeline Tracker is working to provide information that subscribers can use in updating their Emergency Operations Plan to provide contingencies for COVID-19.  There are no approved treatments for COVID-19. But several researchers and pharmaceutical companies are conducting or designing clinical trials to test potential treatments.

We currently are tracking drugs and vaccines for the treatment or prevention of COVID-19 infections in the pages listed below. Whenever possible, we have included published information or grey literature announcements for clinical results. We also include dosing used in clinical trials or reported in cases or case series, clinical trials for the drug, and information on expanded access programs if one exists. Our COVID-19 pages can be accessed by clicking on the link below or through the drop-down menu under COVID-19.

A revised (3/28/2022) ICER review of drugs that are effective to treat the COVID-19 Omicron variant found that compared to no active treatment:
  1. Nirmatrelvir/ritonavir (Paxlovid) likely has at least a small net health benefit and the possibility of a substantial net health benefit.
  2. Molnupiravir is at least comparable and has potential for a small net health benefit.
  3. Sotrovimab likely delivers at least a small benefit with the possibility of a substantial net health benefit. However, the report expressed concern for decreased susceptibility for the BA.2 Omicron Subvariant.
  4. Fluvoxamine is at least comparable and has potential for a small net health benefit. However, NIH has determined there is not enough evidence to recommend for or against the use of fluvoxamine to treat COVID-19.​ 
Due to differences in trial population demographics, ICER did not feel the drugs could be compared based on current evidence. All four drugs were found to be cost effective, with a quality-of-life year gained (QALY) < $100,000. The cost of an averted hospitalization was also < $100,000.

Current Updates for COVID-19
Vaccines being developed to prevent COVID-19
​Antivirals being developed to treat COVID-19
​Blood-derived products under evaluation for the treatment of COVID-19
Anti-Inflammatories being tested to treat cytokine storm associated with severe and critical COVID-19 
Remdesivir Expanded Summary
Ivermectin Expanded Summary

​ COVID-19 Preparedness Resources

The Department of Health and Human Services (HHS) has created a summary table of outpatient treatments of mild-to-moderate COVID-19. The table includes Paxlovid, Molnupiravir, Sotrovimab, Bamlanivimab/Etesevimab and Casirivimab/Imdevimab.

NIH recommends that nonhospitalized patients with mild to moderate COVID-19 who are at high risk of disease progression, be treated with (in order of preference):
  1. Nirmatrelvir 300 mg with ritonavir 100 mg orally twice daily for 5 days and initiated within 5 days of symptom onset in patients at least 12 years old, who weigh at least 40 Kg. The patient’s current drugs should be reviewed for drug interactions using data provided from NIH.
  2. Remdesivir 200 mg IV on Day 1, followed by remdesivir 100 mg IV daily on Days 2 and 3, initiated within seven days of symptom onset in in patients at least 12 years old, who weigh at least 40 Kg.
Alternative Therapies if nirmatrelvir boosted with ritonavir or remdesivir are not available or an inappropriate choice for the patient, then one of the following therapies can be used.
  • Bebtelovimab 175 mg as a single IV infusion, administered as soon as possible and within 7 days of symptom onset in those aged ≥12 years and weighing ≥40 
  • Molnupiravir 800 mg orally twice daily for 5 days, initiated within 5 days of symptom onset in patients at least 18 years and only when none of the above options can be used. Molnupiravir is not recommended in pregnant patients due to concerns for fetal toxicity, but the drug can be considered if none of the other recommended treatments are available. Molnupiravir has not been tested in vaccinated patients.​
Additional Considerations
  • Neither remdesivir, dexamethasone, or baricitinib should be continued after hospital discharge.
  • Dexamethasone 6 mg PO once daily for the duration of supplemental oxygen (dexamethasone use should not exceed 10 days) with careful monitoring for adverse effect.
  • Remdesivir can be considered for up to five days in outpatients requiring supplemental oxygen.
Current treatment recommendations from NIH for hospitalized patients are organized by severity of disease in an easy-to-use graphic.
  • Hospitalized patients requiring supplemental oxygen, but not high flow oxygen or ventilation should receive remdesivir, dexamethasone plus remdesivir or dexamethasone alone. Baricitinib or tocilizumab should be added for patients with increasing oxygen requirement and systemic inflammation.
  • Hospitalized patients requiring high-flow oxygen or non-invasive ventilation should receive dexamethasone or remdesivir plus dexamethasone. Baricitinib or tocilizumab should be added for patients with increasing oxygen requirement and systemic inflammation.
  • Hospitalized patients requiring mechanical ventilation or ECMO should receive dexamethasone. Tocilizumab should be added in patients within 24-hours of being admitted to an ICU. If tocilizumab is not available, sarilumab can be used.
NIH found there is insufficient evidence to recommend either for or against the use of GM-CSF inhibitors (lenzilumab, otilimab, or mavrilimumab) for the treatment of hospitalized patients with COVID-19.

FDA COVID-19 Resource Page

CDC COVID-19 Resources Home Page
 
NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines
 
Comprehensive Hospital Preparedness Checklist for Coronavirus Disease 2019 (COVID-19)
 
CDC Resources for Hospitals and Healthcare Professionals Preparing for Patients with Suspected or Confirmed COVID-19
 
World Health Organization (WHO): Coronavirus disease (COVID-19) technical guidance

Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

The Society of Critical Care Medicine Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) 

JAMA: Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19)

Infectious Diseases Society of America Guidelines on Infection Prevention in Patients with Suspected or Known COVID-19

Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 19) Treatment

ASHP Coronavirus Disease 2019 (COVID-19) Resource Page
 
ASHP Review of Evidence for COVID-19 Treatments
 
Johns Hopkins COVID-19 case counts by country
 
NEJM COVID-19 resources
 
JAMA COVID-19 Resource Center
 
JAMA COVID-19 ICU Care Review
 
Online References
 
Information on Investigational Drugs to Treat COVID-19 - Because information is announced or published on almost a daily basis, be sure and check the revision date. These sources currently do not include information on investigational monoclonal antibody, immunoglobulin or vaccines, which can be found in the Prescribe Right COVID-19 Investigational Drug Tracker.
  • The drugs references such as Facts & Comparisons, Micromedex, Lexicomp and Clinical Pharmacology have added information regarding some of the drugs being investigated to treat COVID-19. Epocrates also has information in a special section under guidelines. 
  • Both UpToDate and Dynamed have monographs on diagnosis and management of COVID-19 patients.
  • Evidenced based review of investigational drug for COVID-19
Subscribe to our knowledgebase to have the most current information investigational drugs by going to our subscription page or arrange for a demonstration of the Pharmaceutical Pipeline Tracker by going to our contact page.