Treatments for COVID-19

We know many patients and their families remain concerned about the risk of severe illness were they to catch COVID-19. This page sets out the developments in the treatment of COVID-19 and how they would be used to treat leukaemia patients, if known.

Although treatments for COVID-19 continue to improve all the time, we encourage everyone to continue to take precautions to reduce the risk of catching COVID-19, such as having COVID-19 vaccines.

From December 16th 2021 the NHS will be offering new treatments to people who catch coronavirus (COVID-19) who are at highest risk of becoming seriously ill. This is with the hope of managing potentially severe COVID-19 symptoms in this group and reducing the risk of becoming seriously ill. 

What treatments are available?

From December 16th 2021 the NHS will be offering new treatments to people who catch coronavirus (COVID-19) who are at highest risk of becoming seriously ill. This is with the hope of managing potentially severe COVID-19 symptoms in this group and reducing the risk of becoming seriously ill. There will be 2 types of COVID-19 treatment available:

  1. sotrovimab (Xevudy) – a monoclonal antibody treatment
  2. molnupiravir (Lagevrio) – an antiviral medicine

Who is eligible?

Everyone who is eligible is receiving a letter to let them know. This letter is not a guarantee you will be treated with these treatments, as you will still be assessed by a doctor if you fall ill with COVID-19. There are various health conditions that make people eligible for the new treatments on the NHS. This has been decided by an independent group of experts advising the government and applies to all 4 UK nations. Below is the list most relevant to leukaemia patients of eligible hematological malignancies:

  • Allogeneic haematopoietic stem cell transplant (HSCT) recipients in the last 12 months or active graft vs host disease (GVHD) regardless of time from transplant 
  • Autologous HSCT recipients in the last 12 months 
  • Individuals who have received chimeric antigen receptor (CAR)-T cell therapy in the last 24 months
  • Individuals who have received radiotherapy in the last 6 months
  • All individuals with haematological malignancies receiving systemic anti-cancer treatment (SACT), e.g. chemotherapy, within the last 12 months. A full list of what counts as SACT can be found here on pages 11 and 12. NB patients with chronic myeloid leukaemia (CML) in molecular response or first or second line tyrosine kinase inhibitors (TKI) are excluded from this.
  • All patients with myeloma (excluding MGUS) or chronic B-cell lymphoproliferative disorders (e.g. CLL and hairy cell leukaemia) or myelodysplastic syndrome (MDS) who do not fit the criteria above
  • All those who are currently on or who have received treatments such as rituximab or JAK inhibitors in the last 12 months, e.g. MPN patients
  • Individuals with non-malignant haematological disorders (e.g. aplastic anaemia) who received treatment such as anti-CD20, antithymocyte globulin [ATG] and alemtzumab within the last 12 months

For a full list please see the relevant NHS guidance here on page 8. If you are not sure if you are eligible please ask your healthcare team.

Note: We are receiving reports that some people not on this list are being sent letters to say they might be eligible. A letter is not a guarantee you will receive the treatment. You will be assessed if you test positive before being given a treatment. Also, clinicians are able to add people to the list if they think they should be eligible.

I’m recently diagnosed with leukaemia, will I get a letter if I am eligible?

If you have been diagnosed since the 15th of November, you may have been missed from the list of people due to receive letters. Speak to your clinical team to see if you should be eligible, then follow the advice below to access the treatments if you test positive for COVID-19.

How can I access these treatments?

If you have symptoms of COVID-19, you should take a PCR test. If you are eligible for the COVID-19 treatments, you will soon be sent a PCR test in the post to keep at home just in case you develop COVID-19 symptoms. This is so that in the first instance you develop symptoms, you can take a PCR test as quickly as possible. If you use your test, the NHS will send you a replacement so that you always have one to hand.

Test kits should be sent out to eligible patients by 10th January 2022. If you’re eligible for treatment and test positive for COVID-19 following a PCR test, you will be contacted by the NHS within 24 hours of the positive test result to explain how to get treatments. 

If you develop COVID-19 symptoms before receiving your home PCR kit, or if you have not had a letter but you believe you are eligible for treatments, you can book a PCR test as normal here. Do this as quickly as possible after you get symptoms, as treatment only works within a certain period of time. If you receive a positive result and don’t hear from the NHS within 24 hours, call your GP or 111 immediately and tell them you think you are eligible for the COVID-19 treatments. They will put you in touch with your local treatment centre for an assessment. 

Which treatment will I get and where will I get it?

If you are eligible, the NHS will advise which treatment is suitable for you.

Monoclonal antibodies are given to you through a drip in your arm (infusion) or by injections. There is a list of locations that are approved to deliver COVID treatments, called COVID Medicines Delivery Units (CMDUs). A list can be found here.

If this is the most appropriate treatment for you, you will get instructions on where to get it and how to get there and back safely.

If you are given molnupiravir, it normally comes as oral capsules which can be taken at home.

A hospital pharmacy will usually arrange for the medicine to be delivered to you or it can be collected by someone else such as a friend, relative or NHS volunteer responder.

What should I do if I believe I am eligible for treatments but have not received a PCR kit at home and/or have not been contacted by the NHS following a positive test?

You should wait until 10th January 2022 to receive a PCR test in the post. However, if you have symptoms of COVID-19 before this date you should get a PCR test by booking online as normal here. If you believe you are eligible and have not received the test by 10th January or you have not been contacted by the NHS within 24 hours of a positive result, you should call 111 or your GP.

What are monoclonal antibodies?

Monoclonal antibodies are antibodies that are created in a laboratory. They are often used in the treatment of cancer, where they are engineered to attach to a protein on the surface of a cancer cell; for example, rituximab is one type used in the treatment of leukaemia. They have also been developed to attach to the COVID-19 virus. When a monoclonal antibody attaches to a COVID virus particle, it encourages the immune system to destroy it, making it more likely that the person will get rid of the virus.

What are antiviral drugs?

Antiviral drugs act directly on the virus to eliminate it, much like an antibiotic for bacteria. Molnupiravir, the antiviral against COVID-19, works by mutagenesis. This means that it causes multiple mutations in the genome of the COVID-19 virus, stopping it from being able to replicate and make more COVID-19 viruses.

Options for those who do not fit into the criteria outlined above

If you are not eligible for COVID-19 treatments on the NHS, you might be able to take part in a study called PANORAMIC. Once you are experiencing symptoms and test positive for COVID-19 on a PCR test you can then enroll in the study here to receive treatments. To be eligible for this study you have to be aged 50 or over, or aged 18 or over with a preexisting condition, including immunosuppression, outlined here.

Summary of other treatments

It is important that we have as wide a variety of treatments as possible. There are other treatments available for those who fall seriously ill and go to hospital. 

All taken from the NICE guidelines for treatment of COVID-19, unless otherwise stated and can be found here

  • Dexamethasone – a steroid treatment, commonly used to treat some leukaemias. Is recommended to treat COVID-19 in people who need oxygen to help them breathe.
  • Remedisivir – an antiviral drug which was hoped to work very well at the start of the pandemic, but since has been shown to have more limited use. It is now only recommended in limited circumstances.
  • One other antiviral has also shown promise; PF-07321332/ritonavir. On the 20th of October 2021, the UK government announced that this would be used as part of ongoing research in the UK and will also be assessed by the Medicines and Healthcare Regulatory Agency to see if it is safe to use more widely. Further information can be found here.

If you have questions, you can contact our support team by calling 08088 010 444, or emailing support@leukaemiacare.org.uk.

Page published on: 22nd October 2021

Page last updated on: 4th January 2022