Treatments for people who are at greater risk of COVID-19

Treatments for people who are at greater risk of Covid 19

Many parents of children aged 12 and over whose immune system puts them at greater risk of COVID 19 have been contacted by the NHS to inform them that they are eligible for new treatments for the virus. You may already have been contacted by NHS nationally or by your care team to confirm that your child might benefit from these treatments and what steps to take.

If you have not been contacted and feel that you should have, your specialist will be able to give you further information about accessing these treatments.

Everyone who has been identified as eligible for COVID 19 treatment is being sent a PCR test (to arrive by January 10) to keep at home and use if they should start showing symptoms (high temperature, new continuous cough or loss or change to sense of smell or taste). So if you have received a PCR test in the past few days and you didn’t specifically request one, this is why! If you need to use the test, you will be sent a replacement.

If your child should show any symptoms, please test as soon as possible. Should the test be positive, the NHS will contact you within 24 hours to give more information and check if treatment is appropriate.

There are currently two types of treatment for people who have tested positive for the virus and are at the highest risk of getting seriously ill:

1. Sotrovimab is a neutralising monoclonal antibody (nMAB) therapy is given through a drip in your arm (infusion). Early data suggests sotrovimab reduces the risk of hospitalisation by 79% in high risk patients. Those prescribed a nMAB treatment will need to travel to a Covid Medicine Delivery Unit to have it administered intravenously.
2. Molnupiravir (also known as Lagevrio) is an oral antiviral. This is a course of treatment that can either be collected by a friend or family member without COVID or delivered to your home. The full course of treatment should be taken, and patients should follow the prescribing clinician’s advice. Data suggests molnupiravir reduces the risk of hospitalisation by 30%. Please note that Molnupiravir is currently only licensed for use in over 18s.

The recommendations for these therapies are based on results from unvaccinated people and due to low numbers of severely unwell children and young people from COVID19, it is challenging to estimate the risks vs benefit, or numbers needed to treat to prevent hospitalisation and severe disease. Therefore, there will be a case-by-case discussion by a team of experts deciding on treatment.

Patients will never have to pay for treatment and the Government has waived prescription charges.

If you have any questions or concerns, please contact our support team at families@childliverdisease.org.

New national study for COVID-19 treatments

The Government has also established a new national study for COVID-19 antiviral treatments called PANORAMIC, run by the University of Oxford, which opened on the 8^th December 2021. The first antiviral treatment to enter the study is Molnupiravir. The Government rolled out a nationwide study so further data can be collected on how this treatment works in a predominantly vaccinated population, to inform wider access in future.

The wider group of at risk patients that are eligible for PANORAMIC includes:

• people who are aged 18 to 49 with an underlying health condition (including chronic liver disease or having had a transplant).
• And who feel unwell with Covid-19 symptoms that started in the last five days
• And who have a positive PCR test.

Patients in this category who would like to take part in the PANORAMIC study must be assessed for treatment by a CMDU first. They can then sign up by going to  www.panoramictrial.org or by calling freephone number 08081 560017.

Participants in the study will be randomly selected to either be in a group who receives a course of oral antiviral treatments, or a group that doesn’t. Two different groups are needed so the study team can see any difference in the health of those who received the antiviral treatment compared to those who didn’t. All participants will be able to access any other NHS care that they would normally expect to receive.