Coronavirus staff guidance University Hospitals Birmingham NHS Foundation Trust

Last updated: 24 January 2025 at 14:40

Patients who deteriorate and require hospital-based care and supplemental oxygen for the management of COVID-19 pneumonia  should be assessed for their eligibility for each of these treatments.

• Heparin
• Dexamethasone
• IL-6 inhibitors (tocilizumab/sarilumab)
• Baricitinib
• Remdesivir

UHB have provided a therapeutics checklist to aid this process as patients may be suitable for multiple treatment combinations and the assessment for each should be clearly documented.

Clinicians are encouraged to proactively support recruitment to trials developing further evidence in the treatment of COVID-19.

Patients in hospital for indications other than management of symptomatic COVID-19 infection may be eligible for treatments to prevent deterioration to pneumonia and subsequent mortality. The UK policy has been updated to provide access to the following antiviral treatment options. A flowchart is available showing how the treatment might be determined.

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• First-line: nirmatrelvir/ritonavir (Paxlovid) (antiviral, 3 tablets twice daily or adjusted for renal function)
• Second-line: remdesivir (antiviral, 200mg IV loading, then 100mg daily for further 2 days)

Exceptionally, sotrovimab may be considered where the available antiviral treatments are deemed unsuitable and its use is supported following multi-disciplinary team (MDT) assessment.

The prescribing of COVID-19 treatments requires pre-authorisation using the Blueteq system detailing the key indications and exemptions.

The process for prescribing and obtaining SARS-CoV-2 treatments is detailed below.