Considerations on the Use of Antivirals, Monoclonal Antibodies, and Other Interventions for the Management of COVID-19 Patients in Latin America and the Caribbean

Abstract

Since the onset of the COVID-19 pandemic, a large number of clinical trials have been planned and developed to assess the effectiveness and safety of various interventions that could prevent hospitalizations and progression to severe disease in people infected with SARS-CoV-2. Currently, the World Health Organization (WHO) and the Pan American Health Organization (PAHO) recommend the use of corticosteroids, tocilizumab, baricitinib, and casirivimab e imdevimab (the latter in seronegative COVID-19 patients) and propose the use of sotrovimab, casirivimab/imdevimab, and molnupiravir in patients with non-severe illness who are at high risk for complications. Other potential therapeutic interventions are currently undergoing study or evaluation by WHO and PAHO. The interventions recommended at present and those that will be recommended at a later date pose challenges in terms of route of administration (e.g., oral or intravenous); efficacy, which depends on the viral variant; establishment of high-risk status (e.g., relative to vaccination status); cost; resources required to administer them; and other implementation-related aspects (e.g., distribution, drug safety monitoring, contraindications, interactions, etc.). To support decision-making for patient management, in this document PAHO presents considerations on the rational use of antivirals, monoclonal antibodies, and other interventions in light of the most current evidence, vaccination status, access, and the costs to countries of the Region.