No oxygen requirement in COVID-19 pneumonia in-patient
Patients can be offered treatment for symptomatic COVID-19, if they meet the following two criteria:
1. They do not require supplemental oxygen, and,
2. They meet high-risk criteria for severe COVID-19 infection as defined in NICE TA878 section 5.
Preferred
Paxlovid®(nirmatrelvir/ritonavir) po BD for 5 days
Start within 5-7 days of symptom onset (see Paxlovid® (Nirmatrelvir/ritonavir) for in-patients for dosing advice)
Paxlovid® (Nirmatrelvir/ritonavir) has an extensive list of drug-drug interactions. Paxlovid® should NOT be prescribed and supplied until a FULL drug history (including prescribed medications, clinical trial medications, over the counter and herbal medicines) has been confirmed and interactions checked.
See the Paxlovid® (Nirmatrelvir/ritonavir) for in-patients drug monograph for important information on drug-drug interactions and dosing in renal impairment.
Alternative (if Paxlovid® not suitable)
Sotrovimab 500mg IV stat
Sotrovimab should be initiated within 5 days of symptom onset.
See Sotrovimab for in-patients for more information.
References
1. National Institute for Health and Care Excellence. Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19. Technology Appraisal guidance TA878, available at Link. Last updated 1/05/25.