WHO Strongly Recommends Paxlovid for Patients at Risk of Severe COVID

The World Health Organization (WHO) recently recommended Pfizer’s Paxlovid in its guidance for COVID-19 patients who are at high risk of hospitalization.

The WHO’s guidelines strongly recommend the use of Paxlovid for people who are immunocompromised or above the age of 65, as well unvaccinated populations. Paxlovid can reduce the risk of hospitalization or death by almost 90% when taken within three to five days of symptom onset.

“For a person who is infected, the antivirals diminish replication, leading to fewer cells infected and lower levels of virus,” Stanley H. Weiss, MD, professor of medicine at the Rutgers New Jersey Medical School, told Verywell. “These can help protect a person who has become infected from disease progression.”

WHO’s Guideline Development Group considers Paxlovid to be the superior choice over other treatment options such as monoclonal antibodies. Based on data, Paxlovid may prevent more hospitalizations and pose less harm to the patient and it is easier to administer because it is taken orally.

“The most important outcome, and the typical primary endpoint of these medications, is the prevention of progression to severe disease and prevention of hospitalization or death,” Carlos Malvestutto, MD, MPH, an infectious disease physician at The Ohio State University Wexner Medical Center, told VeryWell. “So the key initial trials for approval are usually done in a patient population that has documented risk factors for progression of disease.”

Malvestutto said antivirals are reserved mostly for high-risk population because low-risk patients would unlikely progress to severe disease even without treatment.

Antivirals Are Not Accessible to Everyone 

There are several antiviral options available in the U.S., such as Merck’s Lagevrio and Paxlovid—both of which are taken orally—and remdesivir, which requires intravenous (IV) infusions.

When antiviral treatments were first made available, they were too scarce in supply. But as the supply has increased, physicians rarely prescribe them. To encourage better utilization of antivirals, the White House is distributing more antivirals to pharmacies that participate in the “Test-to-Treat” program, so that eligible people who test positive can get the medication on the spot.

Before the antiviral expansion, patients who needed antivirals must get a prescription from their healthcare providers within five days of symptom onset and search for a pharmacy.

“At this time, only patients with documented risk factors are eligible to be prescribed these medications based on the requirements of the EUA,” Malvestutto said. “If you have risk factors and test positive for COVID, contact your healthcare provider as early as possible to be evaluated to receive one of these antivirals.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.