If you are at high risk for severe illness from COVID-19, you may qualify for antiviral treatments, including oral antiviral treatments. Montefiore Medical Center will be offering prescriptions for Nirmatrelvir/Ritonavir (Paxlovid), Lagevrio (Molnupiravir), or appointments for IV Remdesivir as the most effective treatments against the current Omicron subvariants.
Speak with your healthcare provider about which therapy is most appropriate for you, or contact us at covidantibodies@montefiore.org.
Monoclonal antibodies are created in a lab and function like naturally occurring antibodies, fighting infections before they cause too much damage. Studies show that when monoclonal antibodies are given intravenously to high risk people diagnosed early with COVID-19, it can prevent hospitalizations and even death.
Montefiore has been offering monoclonal antibody treatment to patients since December 2020 in our Montefiore Bronx Emergency Departments and a dedicated infusion suite.
There are multiple monoclonal antibody therapies available, which have been authorized by the Food and Drug Administration. Montefiore only administers therapies which are proven to have activity against the major circulating variant.
The monoclonal antibody treatment is given intravenously, administered through a vein in the arm, within one hour. Patients are evaluated by a provider and monitored for any allergic reactions, which are extremely rare. The appointment takes two to three hours to complete; afterward, patients receive a follow-up phone call within a few days to ensure that they are improving. You must be within 7-10 days of symptom onset to qualify.
Starting early December 2022, patients presenting within seven days of symptoms who are at highest risk for severe COVID-19 due to moderate-to-severe immunocompromise, and who cannot receive oral antivirals, may be eligible for a three-day consecutive course of outpatient IV remdesivir at the Montefiore COVID-19 Outpatient Therapeutics Program at 1575 Blondell Avenue, Bronx, NY 10461. Treatment will be offered Monday – Friday. Patients must be willing to come to our infusion center for three consecutive days. Others will be offered oral antiviral medications if no contraindications.
For more information, please contact us at (844) 444-CV19 or CovidAntibodies@montefiore.org
There are two oral antivirals available under Emergency Use Authorization by the FDA. These are nirmatrelvir/ritonavir (Paxlovid) and Molnupiravir. The first is preferred because of greater effectiveness against COVID-19. Unlike monoclonal antibodies, these agents can be taken at home. As with monoclonal antibodies, patients are eligible if they have recently developed COVID-19, have tested positive by PCR or antigen test, and have any high risk condition listed below. A prescription can be sent by your healthcare provider, or your provider can consult our program at the information listed below. You must be within five days of onset of your symptoms to qualify.
To qualify, you must have tested positive for COVID-19 recently (by antigen or PCR test); have mild to moderate symptoms that are managed without oxygen support; and fall into one of the high risk categories below. These treatments are not for patients who are hospitalized for COVID-19.
You're eligible if you have any ONE of the following:
- Older Age (for example, 55-65 years and up)
- Chronic heart disease
- COPD/chronic respiratory disease, including moderate asthma or emphysema
- Diabetes (Type 1 or Type 2) on chronic medications
- Chronic kidney disease
- Immunosuppression due to a chronic medical condition (for example, active cancer, HIV, organ transplant, and others)
- You're taking medicine that weakens your immune system
- Pregnant (or recently delivered)
- Neurodevelopmental, genetic, or metabolic disorder like Cerebral Palsy
- Member of a racial or ethnic minority group at increased risk for severe Covid-19
- Sickle Cell Disease
- Medical technology dependent (trach, feeding tube, etc.)
12 to 17 years of age and at least 40 kg (88 pounds) with any of the following:
- BMI greater than or equal to 85 percent of patients of the same age and gender
- Regularly uses medical technology such as a ventilator or feeding tube
- Have a developmental condition like cerebral palsy
- Sickle cell disease
- Congenital or acquired heart disease
- Asthma/chronic respiratory problems requiring daily medication for control
The U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for AstraZeneca’s Evusheld™, a combination of two monoclonal antibodies (tixagevimab and cilgavimab) designed to prevent COVID-19 infection in immunocompromised individuals who may not mount an adequate antibody response to COVID-19 vaccination.
It is extremely important that all high-risk, eligible patients receive the bivalent booster mRNA vaccine prior to being considered for Evusheld. This is necessary to offer maximum coverage against the various Omicron subvariants which may resist neutralization by Evusheld.
Evusheld is given as two intramuscular injections (300mg each) during the same visit at the Montefiore COVID-19 Monoclonal Antibody Infusion Program.
The FDA has given Emergency Use Authorization for Evusheld to be administered to adults and pediatric individuals (12 years of age and older weighing at least 88 pounds or 40 kg) who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual with COVID-19, and
- Who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and may not mount an adequate immune response to COVID-19 vaccination
- Or for whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe, life-threatening adverse reaction
Moderate to severe immune compromise includes:
- Receiving active chemotherapy for any solid tumor malignancy
- Hematological malignancy
- Solid organ transplant and are taking immunosuppressants
- Receipt of chimeric antigen receptor (CAR)-T-cell therapy within 2 years or maintained on immunosuppression
- Hematopoietic cell transplant within past 2 years or maintained on immunosuppression or IgG replacement
Primary immunodeficiency
- Advanced or untreated HIV infection (i.e., CD4 < 200)
- Graft versus host disease receiving immunosuppression
- Receiving T- or B- cell depleting drug
- Anatomic or functional asplenia
- Sickle cell anemia or thalassemia
- Aplastic anemia
- Neutropenia (ANC < 1000)
- Myelodysplastic syndrome on therapy
- Any other immunosuppressive conditions receiving immunotherapy (e.g., rheumatoid arthritis or lupus, on immunosuppressants)
After a discussion with your doctor about your eligibility, you or your doctor can place a referral by calling 1-844-444-CV19 option #3 or by emailing covidantibodies@montefiore.org (please include your contact information for call back). Doctors within the Montefiore system can email COVIDASP@montefiore.org to place referrals.
Please contact us at (844) 444-CV19 or CovidAntibodies@montefiore.org
To schedule an appointment, please call 1-844-444-CV19.
1575 Blondell Ave, Suite 125, 2nd Floor
Bronx, NY 10461
718-405-8125
CovidAntibodies@montefiore.org
Business Hours: Monday - Friday 8:30am - 5:00pm
To schedule a consultation, please call 1-844-444-CV19.
Longstanding inequities and chronic disease have led to high COVID-19 infection rates and significant risk of death in the Bronx. Now Bronx residents have a safe, evidence-based treatment that stops COVID-19 in its tracks and is preventing severe illness.
