Josie Gold wanted to do everything she could to avoid becoming seriously ill after she came down with COVID-19 in late February.
But after a virtual appointment with Oregon Health & Science University physician, Gold learned her only treatment option was remdesivir, because other therapies could dangerously interact with her routine prescription medications. So, for three mornings in a row, she visited OHSU’s COVID-19 therapy clinic in Portland’s South Waterfront neighborhood to receive infusions of the antiviral medication.
“I was feeling really crappy when I came in for my first infusion,” said Gold, 47, of Portland. “But the next day, I had less fatigue and significantly fewer muscle aches. And it became easier for me to breathe. I improved slowly and steadily, and I’m grateful that I was able to receive that treatment.”
OHSU is the only hospital in Oregon that offers remdesivir — which prevents people from developing severe and potentially life-threatening COVID-19 — for patients who aren’t hospitalized.
Also known by the brand name Veklury, remdesivir is an antiviral medication that interrupts the production of the virus that causes COVID-19. Although this COVID-19 treatment is FDA-approved for both hospitalized and non-hospitalized patients, the closest hospitals that currently provide it to patients who aren’t in the hospital are located in northern Idaho and Sacramento, California.
Patients with mild or moderate symptoms receive remdesivir through three daily intravenous infusions that are given at a hospital over the course of a few hours. As health systems continue to experience staffing shortages and the number of COVID-19 cases has declined, fewer hospitals are offering remdesivir infusions.
“Even though we’re in a much better place today, the pandemic isn’t over, and patients who get sick still need help,” said Young Yoon “YY” Ham, Pharm.D., an infectious disease pharmacist who supports the OHSU COVID-19 therapy clinic. “Receiving treatment within days of becoming sick is especially important for those who have a higher risk of getting severely sick with COVID-19. I want to make sure Oregonians know that we’re still here to help and to contact us as soon as they are sick, as remdesivir is most effective when it is given early, when the symptoms are still mild.”
People who have a higher risk for developing serious COVID-19 include those who are older than 50; have certain medical conditions like high blood pressure, diabetes or obesity; or take immune-compromising medications like those for organ transplant patients or the biologics used to treat skin conditions such as psoriasis and eczema. Most patients can be treated with oral medications, but for those who cannot, remdesivir may be their only effective option.
Currently, three drugs are approved or authorized in the U.S. to treat COVID-19: an oral medication with the brand name Paxlovid, which includes two different drugs, nirmatrelvir and ritonavir; the infusion remdesivir; and another oral medication, molnupiravir, which is also known by the brand name Lagevrio. Paxlovid is the first treatment that’s usually recommended to prevent COVID-19 from becoming severe. But some patients with severe kidney or liver disease can’t take Paxlovid, and others can’t use it because it interacts with their other medications. For those patients, the next-best option is remdesivir. The NIH recommends the third option, molnupiravir, when the first two aren’t available.
All three treatments work best when used shortly after symptoms begin. Experts recommend Paxlovid and molnupiravir be taken within five days of when symptoms first appear, while remdesivir infusions should be started within seven days.
Roughly three weeks after Gold received remdesivir, she says she didn’t experience as severe of a respiratory infection as her husband. He came down with COVID-19 a few days before her, but wasn’t able to access treatment before the required timeline. Despite a lingering cough and some continued fatigue, Gold has been able to return to work and is again caring for local pets as a veterinarian.
“I’m so glad that I was able to get this treatment,” Gold said. “I was fortunate in many ways: I am vaccinated, which I know reduces COVID-19 severity, and I live in a place where this treatment is available. I want others to know this can be a good option for them, too.”
OHSU COVID-19 Therapy Clinic:
The OHSU COVID-19 therapy clinic offers remdesivir Monday through Friday; appointments are required. Patients receive the antiviral infusions in private rooms, with the support of OHSU nurses. Each appointment lasts about three hours, which includes both administering the infusion and a waiting period to ensure patients respond well.
To make an appointment with the COVID therapy clinic, patients first need to visit with an OHSU immediate care provider who can determine which treatment option is best. Virtual immediate care visits can be scheduled online, while telephone and in-person immediate care visits are scheduled by calling 503-494-1700.