COVID-19 Therapeutics Clinic

COVID-19 Therapeutics Clinic

Scarborough Health Network (SHN) is pleased to offer treatment for high-risk patients who have been diagnosed with COVID-19 through our COVID-19 Therapeutics Clinic, located at Centenary Hospital. This clinic is aligned with direction from Ontario Health, providing eligible patients in our community with access to one of two treatment types.

COVID-19 treatments must be started within 5-7 days of symptoms. If you are experiencing COVID-19 symptoms and are at high risk of serious illness, you should immediately seek testing and care, by contacting your family doctor or health care provider or by visiting a clinical assessment centre.

Treatment Options

Paxlovid

  • Paxlovid is an oral mediation (pill) made up of two antiviral agents packaged together that can block the COVID-19 virus from multiplying in the body. Paxlovid can reduce the risk of mild or moderate COVID-19 infections from developing into severe infections that requires high-risk patients to be hospitalized.
  • Paxlovid is administered orally for 5 days.
  • Ontario has expanded dispensing locations for Paxlovid to include participating pharmacies. Physicians in the community can now prescribe Paxlovid with patients being able to pick up the medication at participating pharmacies.
  • Physicians and pharmacists dispensing the drug will need to consider renal function with respect to drug dosing and be mindful of potential drug interactions.
  • Patients with clinically significant and difficult to manage drug interactions may be referred to SHN’s COVID-19 Therapeutics Clinic.

Who is eligible for Paxlovid?


Treatment must be initiated within 5 days of the onset of COVID-19 symptoms.


Patients who have tested positive for COVID-19 (PCR, rapid molecular, or rapid antigen test [including self-administered]) with mild or moderate COVID-19 infection and are at higher risk of clinical progression to severe disease, and do not have contraindications.

Patients may be at higher risk of severe disease if they are in one of the following groups:

  • Immunocompromised or immunosuppressed individuals not expected to mount an adequate immune response to COVID-19 vaccination
  • 70 years of age and older
  • 60 year of age and older with less than three vaccine doses
  • 18 years of age or older with less than three vaccine doses and at least one risk factor*

Immunocompromised or immunosuppressed individuals criteria

Patients must meet at least one of the following criteria:

  • Active treatment for solid tumor and hematologic malignancies (including individuals with lymphoid malignancies who are being monitored without active treatment)
  • Receipt of solid-organ transplant and taking immunosuppressive therapy
  • Receipt of chimeric antigen receptor (CAR)-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency, Good’s syndrome, hyper IgE syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids (i.e. equal or greater than 20 mg prednisone or equivalent per day when administered for equal or greater than 2 weeks)
  • Active treatment with alkylating agents, antimetabolites (including methotrexate), transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis factor (TNF) blockers or other biologic agents that are immunosuppressive or immunomodulatory

List of Risk Factors

  • Diabetes Mellitus
  • Obesity (Body mass index equal or greater than 30 kg/m2)
  • Cardiovascular Disease (e.g. heart disease, congestive heart failure, hypertension)
  • Chronic Kidney Disease (eGFR 30 to less than 60 mL/min/1.73 m2)
  • Chronic Liver Disease (Child-Pugh class B)
  • Chronic Respiratory Disease (including cystic fibrosis)
  • Cerebral Palsy
  • Intellectual or Developmental Disability
  • Sickle Cell Disease
  • Pregnancy

Remdesivir

    • Remdesivir is an antiviral medication which inhibits viral replication. Remdesivir can reduce the risk of mild or moderate COVID-19 infections from developing into severe infections that requires high-risk patients to be hospitalized.
    • This therapy is administered through an IV infusion done onsite at our clinic over a three-day course.
    • A patient who is eligible for Paxlovid may not necessarily be eligible for remdesivir. Remdesivir is not a direct alternative to Paxlovid and the remdesivir-specific inclusion criteria must be met.
    • High-risk patients who are on essential medications that cannot be co-administered with Paxlovid due to drug interactions may benefit from assessment by SHN’s COVID-19 Therapeutics Clinic. We encourage healthcare providers to refer these patients, and our clinic team will follow up to assess and determine the appropriate course of action.

Who is eligible for Remdesivir?


Treatment must be initiated within 7 days of COVID-19 symptoms onset.


Patients who have tested positive for COVID-19 (PCR, rapid molecular, or rapid antigen test [including self-administered]) with mild or moderate COVID-19 infection and are at higher risk of clinical progression to severe disease. Patients with contraindications to Paxlovid or have drug-drug interactions that prohibit Paxlovid administration may be eligible for remdesivir if least one of the following criteria is met:

Immunocompromised or immunosuppressed individuals not expected to mount an adequate immune response to COVID-19 vaccination

Patients must meet at least one of the following criteria:

  • Active treatment for solid tumor and hematologic malignancies (including individuals with lymphoid malignancies who are being monitored without active treatment)
  • Receipt of solid-organ transplant and taking immunosuppressive therapy
  • Receipt of chimeric antigen receptor (CAR)-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency, Good’s syndrome, hyper IgE syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids (i.e. equal or greater than 20 mg prednisone or equivalent per day when administered for equal or greater than 2 weeks)
  • Active treatment with alkylating agents, antimetabolites (including methotrexate), transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis factor (TNF) blockers or other biologic agents that are immunosuppressive or immunomodulatory

Unvaccinated (0 doses of any COVID-19 vaccine)

Patients must meet at least one of the following criteria:

  • Age 70 years or older
  • Age 40 years or older with 1 or more risk factors*
  • Age 12 years or older with 3 or more risk factors*
  • Pregnant

* List of Risk Factors: 

  • Indigenous (First Nations, Inuit, or Métis)
  • Members of Racialized Communities (e.g. Arab, Middle Eastern, Black, Latin American, Indo-Caribbean, South Asian, Southeast Asian, or West Asian)16
  • Obesity (Body mass index equal or greater than 30 kg/m2)
  • Cardiovascular Disease (including hypertension)
  • Cerebral Palsy
  • Chronic Kidney Disease (eGFR less than 60 mL/min/1.73 m2 or dialysis)
  • Chronic Liver Disease (Child-Pugh class B or C)
  • Chronic Respiratory Disease (including cystic fibrosis and asthma)
  • Diabetes Mellitus
  • Intellectual Disability
  • Sickle Cell Disease

Vaccinated with 1 or 2 doses of a COVID-19 vaccine

Patients must meet at least one of the following criteria:

  • Age 70 years or older with 1 or more risk factors*
  • Age 20 years or older with 3 or more risk factors*

* List of Risk Factors: 

  • Indigenous (First Nations, Inuit, or Métis)
  • Members of Racialized Communities (e.g. Arab, Middle Eastern, Black, Latin American, Indo-Caribbean, South Asian, Southeast Asian, or West Asian)16
  • Obesity (Body mass index equal or greater than 30 kg/m2)
  • Cardiovascular Disease (including hypertension)
  • Cerebral Palsy
  • Chronic Kidney Disease (eGFR less than 60 mL/min/1.73 m2 or dialysis)
  • Chronic Liver Disease (Child-Pugh class B or C)
  • Chronic Respiratory Disease (including cystic fibrosis and asthma)
  • Diabetes Mellitus
  • Intellectual Disability
  • Sickle Cell Disease

Vaccinated with 3 doses of a COVID-19 vaccine

  • Age 70 years or older with 3 or more risk factors*

* List of Risk Factors: 

  • Indigenous (First Nations, Inuit, or Métis)
  • Members of Racialized Communities (e.g. Arab, Middle Eastern, Black, Latin American, Indo-Caribbean, South Asian, Southeast Asian, or West Asian)16
  • Obesity (Body mass index equal or greater than 30 kg/m2)
  • Cardiovascular Disease (including hypertension)
  • Cerebral Palsy
  • Chronic Kidney Disease (eGFR less than 60 mL/min/1.73 m2 or dialysis)
  • Chronic Liver Disease (Child-Pugh class B or C)
  • Chronic Respiratory Disease (including cystic fibrosis and asthma)
  • Diabetes Mellitus
  • Intellectual Disability
  • Sickle Cell Disease

How the clinic works

Getting a referral

All patients require a referral to be seen at the COVID-19 Therapeutics Clinics.

Patients may get a referral through:


Initial virtual assessment

All patients who have been referred to the COVID-19 Therapeutics Clinic will have an initial assessment with our clinic team. This assessment will be scheduled as a virtual appointment.


Receiving treatment

Following the initial assessment, patients who are eligible will be started on the appropriate treatment:

If Paxlovid is appropriate

Our clinic will determine the best course of action to order and dispense Paxlovid medication for patients. This may be at a participating local pharmacy or onsite at our clinic.

One dose of Paxlovid consists of two or three pills that are taken twice a day over five days. While taking their pills at home, patients should continue to follow COVID-19 measures as directed by public health.

If Remdesivir is appropriate

Patients will be scheduled to receive their Remdesivir infusions onsite at the clinic.

During their infusions, patients will first meet with the clinic team to check their vital signs and go over any questions.

Remdesivir is administered through intravenous (IV) infusion over a three-day course. Each infusion will take one hour.

Following each infusion, patients may go home and continue any COVID-19 measures that have been directed to them by public health. Once their three-day course of infusions is complete, no further infusions will be needed.

Learn More

Contact Us

COVID-19 Therapeutics Clinic
Centenary Hospital, 4th Floor
Phone: 416-281-7442
Fax: 416-281-7384

Make a Referral

Referral from a physician or a Clinical Assessment Centre required. Please fax to 416-281-7384.