Coronavirus (COVID-19): Treatments

Getting your coronavirus (COVID-19) vaccination is still the best way to protect yourself from the virus.

There are additional treatment options for selected groups of people with coronavirus who are thought to be at greater risk. These treatments need to be given soon after you get a positive coronavirus test result to be most effective.

These additional coronavirus treatments are available to:

those thought to be at high risk with a clinical condition that's been prioritised for treatment
those taking part in a registered clinical trial of antiviral and other therapies for coronavirus

Direct access to coronavirus treatments for patients with clinical conditions prioritised for treatment

Adults and children (aged 12 or over) who have all 3 of the following are eligible to be assessed for treatment:

symptoms of coronavirus that started in the last 5 days with no signs of clinical recovery
are a member of one of the patient groups considered at high risk from coronavirus with a clinical condition prioritised for treatment
coronavirus is confirmed by either a positive lateral flow device (LFD) test or PCR test

Your LFD test is not complete until you report your result, either online or by phone, and receive a result confirmation notification.

Adults 18 years or older considered at high risk from coronavirus and to be prioritised for treatment

The following patient groups were determined by a group of clinical experts using the best available evidence on outcomes in coronavirus infection. More detailed information can be found in the published report of the independent advisory group.

Down's syndrome and other genetic disorders

Down's syndrome or other chromosomal disorders known to affect the immune system

Solid cancer

metastatic or locally advanced inoperable cancer
lung cancer (at any stage)
people who have received chemotherapy, PI3K inhibitors or radiotherapy within the last 12 months
people who have had cancer surgically removed within the last 12 months and are receiving no follow-up chemotherapy or radiotherapy (with the exception of people with basal cell carcinomas who have undergone local excision or topical treatment)

Haematological (blood) diseases and stem cell transplant recipients

sickle cell disease
allogeneic haematopoietic stem cell transplant (HSCT) recipients in the last 12 months or active graft vs host disease (GVHD) regardless of time from transplant (including HSCT for non-malignant diseases)
autologous HSCT recipients in the last 12 months (including HSCT for non-malignant diseases)
individuals with haematological malignancies who have received chimeric antigen receptor (CAR)-T cell therapy in the last 24 months, or radiotherapy in the last 12 months
individuals with haematological malignancies receiving systemic anti-cancer treatment (SACT) within the last 12 months

All people who are diagnosed with:

myeloma (excluding monoclonal gammopathy of undetermined significance (MGUS))
AL amyloidosis
chronic B-cell lymphoproliferative disorders (e.g. chronic lymphocytic leukaemia, follicular lymphoma)
myelodysplastic syndrome (MDS)
chronic myelomonocytic leukaemia (CMML)
myelofibrosis
people with thalassaemia or rare inherited anaemia with either severe cardiac iron overload or severe to moderate iron overload with an additional comorbidity of concern (for example, diabetes, chronic liver disease or severe hepatic iron load on MRI) and where agreed by the
haematology consultant responsible for the management of the patient’s haematological condition
individuals with non-malignant haematological disorder (e.g. aplastic anaemia or paroxysmal nocturnal haemoglobinuria) receiving B-cell depleting systemic treatment (e.g. anti-CD20, anti thymocyte globulin [ATG] and alemtuzumab) within the last 12 months

Renal (kidney) disease

renal transplant recipients (including those with failed transplants within the past 12 months), particularly those who have:
- received B cell depleting therapy within the past 12 months (including alemtuzumab, rituximab [anti-CD20], anti-thymocyte globulin)
- an additional substantial risk factor which would in isolation make them eligible for nMABs or oral antivirals
- not been vaccinated prior to transplantation
non-transplant patients who have received a comparable level of immunosuppression
people with chronic kidney stage (CKD) 4 or 5 (an eGFR less than 30 ml/min/1.73m2) without immunosuppression

Liver disease

people with cirrhosis Child’s-Pugh class A, B or C
people with a liver transplant
people with liver disease on immune suppressive therapy (including patients with and without cirrhosis)

Immune-mediated inflammatory disorders (IMID)

people who have received a B cell depleting therapy (anti-CD20 drug for example rituximab, ocrelizumab, ofatumumab, obinutuzumab) in the last 12 months
people who have been treated with cyclophosphamide (IV or oral), biologic medicines or small molecule JAK-inhibitors (except anti-CD20 depleting monoclonal antibodies) in the last 6 months
people who have been treated with corticosteroids (equivalent to greater than 10mg per day of prednisolone) in the last 28 days
people who are on current treatment with mycophenolate mofetil, oral tacrolimus, azathioprine/mercaptopurine (for major organ involvement such as kidney, liver and/or interstitial lung disease), methotrexate (for interstitial lung disease) and/or ciclosporin
people who exhibit at least one of:
- (a) uncontrolled or clinically active disease (that's required recent increase in dose or initiation of new immunosuppressive drug or IM steroid injection or course of oral steroids within the 3 months prior to positive PCR); and/or
- (b) major organ involvement such as significant kidney, liver or lung inflammation or significantly impaired renal, liver and/or lung function)

Immune deficiencies

common variable immunodeficiency (CVID)
undefined primary antibody deficiency on immunoglobulin (or eligible for Ig)
hyper-IgM syndromes
Good’s syndrome (thymoma plus B-cell deficiency)
severe Combined Immunodeficiency (SCID)
autoimmune polyglandular syndromes/autoimmune polyendocrinopathy, candidiasis, ectodermal dystrophy (APECED syndrome)
primary immunodeficiency associated with impaired type I interferon signalling
x-linked agammaglobulinaemia (and other primary agammaglobulinaemias)
any person with a secondary immunodeficiency receiving or eligible for, immunoglobulin replacement therapy

HIV/AIDS

people with high levels of immune suppression, have uncontrolled/untreated HIV (high viral load) or present acutely with an AIDS defining diagnosis
people on treatment for HIV with CD4 <350 cells/mm3 and stable on HIV treatment or CD4>350 cells/mm3 and additional risk factors (e.g. age, diabetes, obesity, cardiovascular, liver or renal disease, homeless, those with alcohol-dependence)

Solid organ transplant recipients

all recipients of solid organ transplants not otherwise specified above

Rare neurological conditions

multiple sclerosis
motor neurone disease
myasthenia gravis
Huntington’s disease

Young people aged 12 to 17 considered at high risk from coronavirus and to be prioritised for treatment

Coronavirus is much less likely to progress to severe disease in people aged 12 to 17, even in those who might be viewed as at increased risk. Only those 12 to 17 year olds assessed as at exceptionally high risk will be offered an infusion of a monoclonal antibody treatment. The oral antiviral treatments are only authorised for use in adults aged over 18 years.

The decision to treat will normally be made by a multi-disciplinary team after carefully weighing the risks and benefits. They'll take into consideration the recommendations from the independent advisory group.

Accessing testing

If you have a health condition which means you may be eligible for new coronavirus treatments, you should keep a pack of lateral flow device (LFD) tests at home. If you develop symptoms use these LFD tests to check whether you have coronavirus. Only use them if you develop symptoms. You can order a free pack for home delivery online or by phoning 119.

Testing is still free of charge if you have a health condition which means you may be eligible for new coronavirus treatments.

When you enter a Scottish postcode, the online order form will say ‘Most people in Scotland can no longer get free rapid lateral flow tests.’ Click 'Continue' if you’re eligible and you’ll be able to order.

Positive LFD result

If your LFD test is positive and you're eligible for treatment you need to do 2 things:

Contact your NHS health board on the number on this page. They'll assess your suitability for treatment. There is no need to take a PCR test to start receiving treatment.
Follow stay at home advice.

Negative LFD result

If your LFD test is negative, but you still have symptoms, you should take another LFD test on each of the next 2 days (3 tests in total over 3 days). If either of these tests is positive, follow the steps for a positive LFD test.

Accessing treatment

The table below provides a phone number for each NHS health board that you can contact if you meet the eligibility criteria. You should contact your health board where you live.

If you test positive while you're away from home (for example on holiday) in any other part of Scotland or the UK, you should still contact your home health board where you permanently live. This is because your home health board in Scotland will have access to more information about you to support any requirements to confirm your eligibility. They'll then help you to access the closest treatment service to where you are temporarily staying.

The phone lines will be open 7 days a week including public holidays. You may reach an answering machine and be asked to leave a message as some areas are operating a call back service.

After contacting the number you'll be assessed for your suitability for treatment.

If eligible, you'll be asked about the medicines that you're currently taking. This is for safety reasons as some medicines can cause serious side effects when taken together. Please have the list of medicines that you're taking handy when you call. This includes medicines prescribed by your GP practice or hospital, medicines prescribed privately outside of the NHS, and any medicines bought from a pharmacy or shop without a prescription.

Remember to also include herbal remedies and vitamin supplements you are taking, as well as medicines that come in patches, inhalers, suppositories, lozenges, gels, ointments, or creams.

The NHS will advise which treatment, if any, is suitable for you. Your clinician may recommend an antiviral treatment to be taken orally. Alternatively, you might have to travel to a day clinic at a hospital to receive a treatment called a monoclonal antibody treatment. This is normally given by intravenous infusion (in your vein). You'll get instructions on where to get the treatment and how to get there and back safely.

These numbers should not be used if you're seeking urgent medical advice or have a general health query.

Health board	Phone number
NHS Ayrshire & Arran	01563 825 610
NHS Borders	01896 827 015
NHS Dumfries & Galloway	01387 241 959
NHS Fife	01592 729 799
NHS Forth Valley	01786 434 110
NHS Grampian	01224 553 555
NHS Greater Glasgow & Clyde	0800 121 7072
NHS Highland	0800 085 1558
NHS Lanarkshire	01355 585 145
NHS Lothian	0300 790 6769
NHS Orkney	01856 888 259
NHS Shetland	01595 743 393
NHS Tayside (open from 9am to 4pm Monday to Friday and from 9am to 1pm Saturday and Sunday)	01382 919 477
NHS Western Isles	01851 601 151

PANORAMIC Research Study

Coronavirus oral antiviral treatments are being evaluated through a study called PANORAMIC, run by the University of Oxford.

People across Scotland took part in the first stage of the study which evaluated a medicine called molnupiravir. This stage of the study has now closed.

The second stage of the study is evaluating a medicine called Paxlovid. This stage is taking place through localised study sites. This is because the health professionals recruiting participants into the study need access to medical record data to see if the medicine is suitable for individuals before they can enter the study.

For more information about the study, and to register your interest in participating, visit the PANORAMIC trial website or contact communications@nrs.org.uk