Covid-19 Group 2 Patients Monoclonal antibodies for patients with hospital-onset COVID-19 (976)


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Neutralising monoclonal antibodies (nMAB) bind to specific sites on the spike protein of the SARS CoV-2 virus particle, blocking its entry into cells and therefore inhibiting its replication.

The following nMABs have conditional marketing authorisation for use in the treatment of COVID-19 in the UK.

Sotrovimab is the only effective nMAB commissioned in Group 2 and the nMAB of choice in GGC 

  • Sotrovimab (Xevudy®) is an nMAB that both blocks viral entry into healthy cells and clears cells infected with SARS-CoV-2. 
  • Casirivimab and imdevimab (Ronapreve®) is a combination nMAB containing equal amounts of casirivimab and imdevimab. Ronapreve should not be used in GGC as at the time of writing this version NHS GGC Omicron prevalence is >90% in the community
  • Remdesivir can be used where an nMAB is not suitable or not available (see below)

The decision to initiate nMAB must be made by a Consultant and be within the defined criteria.

If a patient does not meet the criteria and nMAB therapy is still felt to be a therapeutic consideration, the Consultant in charge of the patient’s care must discuss the case with at least one other Consultant who has expertise in the management of COVID, for example the on call Infectious Diseases or Respiratory Consultant. It may be that a broader MDT discussion is required in complex cases. The summary and outcome of this discussion, along with the names of the clinicians involved in the
discussion, must be clearly documented in a clinical note on Portal.


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Last reviewed: 16 February 2022

Next review: 24 February 2023

Author(s): Samantha Carmichael

Version: 3 author version 4.0

Author Email(s): [email protected]

Approved By: Covid-19 Tactical Group (Acute)

Document Id: 976