COVID-19 pneumonia - in-patient NOT requiring supplemental oxygen
Patients who meet the following criteria can be offered treatment for symptomatic COVID-19:
- Do not require supplemental oxygen and
- Meet the criteria as defined in NICE TA878 (see sections 1 and 5).
Outpatients requiring treatment can be referred to the Oxfordshire COVID-19 Medicines Delivery Unit (CMDU) by e-mailing ouh.cmdu@ouh.nhs.uk
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. Casirivimab plus imdevimab, nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19.Technology Appraisal guidance TA878 available at: Link.Last updated 13/03/24.
2. Department of Health and Social Care.Independent report: Defining the highest risk clinical subgroups upon community infection with SARS-CoV-2 when considering the use of neutralising monoclonal antibodies (nMABs) and antiviral drugs (updated March 2023) available at: Link