Covid-19: Deployment of treatment for highest risk non-hospitalised patients

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Under Review — this page was due to be reviewed by Tuesday, 19 April 2022. The information shown here may be outdated.

Update February 2022

The NHS is offering new antibody and antiviral treatments to people with Covid-19 who are at highest risk of becoming seriously ill. The treatments available are:

  • nirmatrelvir and ritonavir (Paxlovid)
  • sotrovimab (Xevudy)
  • remdesivir (Veklury)
  • molnupiravir (Lagevrio)

Nirmatrelvir, ritonavir, remdesivir and molnupiravir are antiviral medicines. Sotrovimab is a biological medicine. It is also known as a neutralising monoclonal antibody (nMAb).

These treatments can help some people manage their Covid-19 symptoms and reduce the risk of becoming seriously ill. They are for people who have not been admitted to hospital.

For more information on the treatments available, please visit the NHS website (right).

University College London Hospitals (UCLH) will be administering new Covid-19 treatments for patients at highest risk in the community from Thursday 16 December 2021. This will begin with prescribing oral antivirals and progress to IV antibody treatments from Monday 20 December 2021.

Neutralising monoclonal antibodies (nMABs) or antiviral treatments for the highest risk non-hospitalised patients with Covid-19 are being given to patients at a dedicated clinic on the ground floor of University College Hospital. This will be known as the nMAB CMDU (Covid-19 Medical Delivery Unit).

nMABs are an intravenous treatment and are recommended to be available as a treatment option for non-hospitalised adults and children (aged 12 years and above) in the nationally identified highest risk patient cohorts. The updated CAS alert has now been published and eligibility is described in Appendix 1. 

More information about the treatments can be found on the MHRA website.  

In addition to the intravenous treatment, the CMDU at UCLH will also offer an oral antiviral as an alternative for patients for whom the intravenous treatment is not feasible/contraindicated. Patients will not need to attend the CMDU for this treatment.

Most of the highest risk patients will receive a letter or email telling them in advance they may be eligible for these treatments in the event they test PCR positive for Covid-19. They will also automatically receive a priority PCR test to keep at home. It is anticipated that 15 per cent of patients will be referred from either 111 services, by their GP, or their specialist who identify patients that are not captured as part of the national database. These referrals will be made via Directory of Services or eRS and clinical triage will then be undertaken by the CMDU.

The CMDU will be operating sufficient hours to enable treatments to be given within the set time frames, with the ambition to deliver a seven day service if required. Patient transport will be provided for those who cannot arrange travel but need to attend the CMDU service for their intravenous infusion. A pharmacy delivery service will also be made available for those who cannot arrange for the collection of their oral antiviral treatments.  

In the event of a positive PCR test, eligible high risk patients will be contacted directly to discuss the treatment and confirm eligibility.

Whittington Health Community services will also be working alongside the CMDU to arrange any ongoing support some patients may need following treatment.

For your information, the patient SMS text message and letter has been attached, along with the easy read patient information leaflet.

For more information about the service, email or call 07526 971 953. 

Review date: Tuesday, 19 April 2022