Therapeutic Options for COVID-19 Patients - Minnesota Dept. of Health
As we learn more about COVID-19, recommendations and guidance are updated frequently. Please check back often.

Therapeutic Options for COVID-19 Patients

Information about investigational therapeutics to be updated as new information emerges.

On this page:
Monoclonal Antibody (mAb) Treatment
    Monoclonal antibody treatment and SARS-CoV-2 variants
    Ethical guidance and eligibility
    General resources
    Regeneron - Casirivimab and Imdevimab
    Eli Lilly – Bamlanivimab and Etesevimab
Ventilators and Cardiopulmonary Resuscitation
Remdesivir

The Minnesota Resource Allocation Platform is an online tool that connects patients and health care providers with COVID-19 medications that are in limited supply.

Monoclonal Antibody (mAb) Treatment

Monoclonal antibody treatments are available through the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for non-hospitalized COVID-19 positive people.

As of 4/16/2021, the FDA has revoked the emergency use authorization (EUA) for bamlanivimab, when administered alone, for the treatment of mild-to-moderate COVID-19 in patients at high risk of disease progression or hospitalization. See the FDA announcement Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Monoclonal Antibody Bamlanivimab. Alternative monoclonal antibody therapies authorized to treat patients with COVID-19 remain available.

Bamlanivimab should no longer be prescribed alone for use in patients with mild to moderate COVID-19 illness. Infusion sites that are using bamlanivimab can order etesevimab alone, bamlanivimab, or casirivimab/imdevimab using the direct ordering process at HHS: Overview of Direct Order Process for COVID-19 Therapeutics. For any infusion sites that have only bamlanivimab on hand and need an alternative supply in the short term, please reach out to your regional health care coalition.

Monoclonal antibody treatment and SARS-CoV-2 variants

Certain circulating SARS-CoV-2 viral variants may be associated with resistance to monoclonal antibodies. Health care providers should review the viral neutralization data in the authorized fact sheets for each mAb available under EUA for details regarding specific variants and resistance (see below). Information on the proportion of SARS-CoV-2 variants circulating in the US is available on the CDC website and will be updated regularly (see below).

Variants are increasing in Minnesota. However, the most common variant identified in Minnesota is B.1.1.7 (also known as the UK variant), which is not thought to impact the efficacy of the two currently available monoclonal treatments. Other variants may have decreased susceptibility to bamlanivimab/etesevimab. These include the B.1.427/9 variants, first identified in California, which is increasing in Minnesota but to a lesser degree than B.117. Other potentially resistant variants that have been found in Minnesota include P.1, B.1.351, and some strains of B.1.525/6, but are currently thought to be at a low prevalence. This is a rapidly evolving area and providers are encouraged to consult with an infectious disease specialist if they have concerns about mAb treatment and variants.

Please note that although sequencing information is helpful on a population level, individual patient results will not be reported back to the provider or submitting laboratory. Whole genome sequencing is not currently approved for use as a diagnostic test to make individual patient treatment decisions. In addition, the lengthy turnaround time for this type of testing means it is unsuitable for treatment decisions involving mAbs, which should be given as soon as possible once a patient has developed symptoms and tests positive.

Ethical guidance and eligibility

General resources

Regeneron - Casirivimab and Imdevimab

Eli Lilly – Bamlanivimab and Etesevimab

Bamlanivimab/etesevimab is now available for use through HHS. This product may be shipped alone for combination with existing supplies of bamlanivimab or as a combination product.

Ventilators and Cardiopulmonary Resuscitation

Remdesivir

Remdesivir is available through the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for people with severe COVID-19.

Thank you for your continued partnership. For health care questions, please contact the MDH provider hotline at 651-201-5414.

Updated Friday, 30-Apr-2021 11:06:21 CDT