Oxygen requirement for in-patient with COVID-19 pneumonia
- Consider prescribing CORTICOSTEROIDS in patients who require supplemental oxygen to maintain prescribed oxygen saturation levels:
- Dexamethasone 6mg (base) daily po or iv for 10 days or until discharge, whichever is sooner.
- In pregnancy or breastfeeding women, prednisolone 40 mg administered by mouth (or intravenous hydrocortisone 80 mg twice daily) should be used instead of dexamethasone.
- Consider need for thromboprophylaxis, see OUH Primary VTE Prevention Guidance for Patients with suspected or proven COVID-19
- Review need for specific COVID-19 treatments discussed below:
Patient requires Non-invasive or invasive Mechanical Ventilation
Discuss patient with Micro/ID.
Low or high flow oxygen treatment
Preferred
Tocilizumab. See monograph Tocilizumab for in-patients for eligibility criteria and dosing information.
Alternative
Baricitinib may be considered in people who cannot have tocilizumab OR when there is clinical deterioration despite treatment with tocilizumab it may be appropriate to add baricitinib. These patients MUST be discussed with Micro/ID. See monograph Baricitinib for in-patients for dosing information.
OR
Remdesivir may be recommended by Micro/ID. See monograph Remdesivir for in-patients for dosing 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.