Table 2.

COVID-19 therapeutics with potential application to travel

Therapeutic agent	Status	Current indication (FDA EUA, NIH)	Possible application for travel	Comments	References
Tixagevimab-cilgavimab (Evusheld)	FDA, EUA	Pre-exposure prophylaxis (PrEP) for adults and adolescents (aged ≥ 12 years and weighing ≥ 40 kg) who do not have SARS-CoV-2 infection, who have not been recently exposed to an individual with SARS-CoV-2 infection, AND who have: •Moderate to severe immunocompromise and may have an inadequate immune response to COVID-19 vaccination; or •A contraindication hence unable to be fully vaccinated with COVID-19 vaccines	Pre-exposure prophylaxis for travelers at high risk of severe disease from COVID-19, who have no symptoms of COVID-19 and no confirmed exposure to COVID-19 within prior 5 days	Long-acting human monoclonal antibody that binds to the spike protein receptor-binding domain (RBD) of SARS-CoV-2 preventing binding affinity to ACE2	[100]
				PROVENT, the unpublished randomized, double-blind, placebo-controlled trial of adults > 59 years or with a pre-specified chronic medical condition or at increased risk of SARS-CoV-2 infection who had not received a COVID-19 vaccine and no history of SARS-CoV-2 infection, found a 77% reduced risk of COVID-19 compared to placebo	[96••]
Nirmatrelvir-ritonavir (Paxlovid)	FDA, EUA	Outpatient treatment of mild-moderate COVID-19 infection in patients at high risk for progressing to severe infection and possible hospitalization	Self-treatment for COVID-19: start within 5 days of symptom onset or positive viral test	A viral protease that cleaves 2 viral polyproteins leading to antiviral activity against all human coronaviruses, and packaged with ritonavir, a cytochrome P450 (CYP) 3A4 inhibitor, to boost nirmatrelvir concentrations	[98]
				EPIC-HR trial demonstrated that starting nirmatrelvir-ritonavir in adults with mild to moderate COVID-19 within 5 days of symptom onset reduced the risk of hospitalization or death through day 28 by 89% compared to placebo
Molnupiravir	FDA, EUA	Outpatient treatment of mild-moderate COVID-19 infection in patients at high risk for progressing to severe infection and possible hospitalization (only in the case that alternative treatment options are not available or appropriate)	Self-treatment for COVID-19: start within 5 days of symptom onset or positive viral test	An oral prodrug of beta-D-N4-hydroxycytidine (NHC), a ribonucleoside that has broad antiviral activity against RNA viruses and inhibits RNA polymerase	[99]
				In the MOVe-OUT trial, molnupiravir reduced the rate of hospitalization or death by 30% compared to placebo

FDA Federal Drug Administration, EUA emergency use authorization