The new NHS England and NHS Improvement guidance provides recommendations for front-line clinicians on the assessment, monitoring, and treatment of patients who present to general practice with symptomatic COVID-19

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NHS England and NHS Improvement has published Assessment, monitoring and management of symptomatic COVID-19 patients in the community. The new guidance is intended to support healthcare practitioners working in general practice who encounter patients with symptomatic COVID-19.

The guidance aims to provide a high-level overview of which patients are eligible for community monitoring and therapeutics for COVID-19, as well as information on how to support patients to access these interventions. The guidance includes chapters on:

  • COVID Oximetry @home monitoring
  • COVID-19 treatment
  • COVID-19 medicines delivery units
  • the UK PANORAMIC clinical study on the use of new antiviral treatments for COVID-19 in the community
  • assessment and treatment pathways
  • additional resources.

COVID-19 treatment in the community

According to the guidance, the highest-risk patients with mild-to-moderate symptoms of COVID-19 should be considered for treatment with new antibody and antiviral treatments, if they are within 5 days of symptom onset.

Two types of community-based COVID-19 treatment are currently available:

  • neutralising monoclonal antibodies—usually given by infusion or injection in a local hospital or health centre
  • oral antiviral treatment—currently molnupiravir (Lagevrio; Merck Sharp & Dohme [UK] Limited) in capsule form that can be taken at home.

Patients who are eligible for these treatments should be referred to COVID-19 medicines delivery units. If, however, patients are ineligible for these treatments, they may be eligible to participate in the PANORAMIC trial, which is investigating whether new antiviral treatments for COVID-19 in the community can reduce the need for hospital admission and shorten recovery times.

The University of Oxford’s PANORAMIC trial, which is operating through 31 sites across the UK, is recruiting participants via its website, and through participating GP practices and other participating NHS sites. Participation in the trial is open to anyone with ongoing symptoms of COVID-19 and a positive polymerase chain reaction or rapid antigen test, regardless of COVID-19 vaccination status.