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 – REGEN-COV (Casirivimab and Imdevimab)
    Eli Lilly – Bamlanivimab and Etesevimab
    GSK – Sotrovimab
Ventilators and Cardiopulmonary Resuscitation
Remdesivir
Tocilizumab
Baricitinib

The Minnesota Resource Allocation Platform is an online tool that connects patients and health care providers with COVID-19 medications. Learn more at COVID-19 Medication Options.

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 September 16, 2021, the FDA has expanded the EUA for bamlanivimab 700 mg and etesevimab 1400 mg administered together to include post-exposure prophylaxis (PEP) in certain people for the prevention of SARS-CoV-2 infection. The neutralizing antibodies can now be used together to treat high-risk people age 12 years and older who have not been fully vaccinated against COVID-19 or are not expected to mount an adequate immune response to complete vaccination, and have been exposed to someone infected with SARS-CoV-2 or who are at high risk of exposure in an institutional setting, including a nursing home or prison.

For more information refer to Emergency Use Authorization for Lilly's bamlanivimab and etesevimab administered together expanded to include post-exposure prophylaxis for COVID-19.

MDH reminds providers that bamlanivimab/etesevimab is not authorized for subcutaneous administration.

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 U.S. is available on CDC COVID Data Tracker: Variant Proportions and will be updated regularly.

Variants are increasing in Minnesota, including variants that have decreased susceptibility to bamlanivimab/etesevimab. 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 – REGEN-COV (Casirivimab and Imdevimab)

REGEN-COV is available for use through HHS allocation and distribution.

REGEN-COV is authorized for both treatment and post-exposure prophylaxis and can be administered by IV or SQ routes.

Eli Lilly – Bamlanivimab and Etesevimab

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

Bamlanivimab/etesevimab is authorized for both treatment and post-exposure prophylaxis and can be administered by IV or SQ routes.

GSK – Sotrovimab

Sotrovimab is both commercially available for purchase and available through HHS.

Sotrovimab is authorized for the treatment of mild to moderate COVID-19 ONLY and can ONLY be administered by IV route.

Ventilators and Cardiopulmonary Resuscitation

Remdesivir

Remdesivir is approved by the FDA, under the name Veklury, for the treatment of COVID-19 in hospitalized adult and pediatric patients (age 12 years and older and weighing 40 kg or more). It is also available through an FDA Emergency Use Authorization (EUA) for the treatment of COVID-19 in hospitalized pediatric patients weighing 3.5 kg to less than 40 kg or age 11 years and younger and weighing  3.5 kg or more. Remdesivir should be administered in a hospital or a health care setting that can provide a similar level of care to an inpatient hospital.

Tocilizumab

Tocilizumab is an interleukin (IL)-6 inhibitor that can be used in hospitalized patients with progressive severe or critical COVID-19 illness that demonstrate elevated markers of inflammation. For a more complete review of the evidence, benefits/harms and treatment criteria, refer to the NIH and IDSA COVID-19 treatment guidelines below:

Baricitinib

Baricitinib is a Janus kinase (JAK) inhibitor that can be used in hospitalized patients with severe COVID-19 disease and elevated inflammatory markers, but not requiring mechanical ventilation. It can also be given in conjunction with remdesivir to hospitalized patients with severe disease who are unable to receive corticosteroids due to a contraindication. For a more complete review of the evidence, benefits/harms and treatment criteria, refer to the NIH and IDSA COVID-19 treatment guidelines below:

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

Updated Thursday, 21-Oct-2021 15:21:39 CDT