Interventions

ASCOT is currently trialling the following treatment approach, called a ‘domain’.

Remdesivir is a medicine used to help people who are sick with certain viruses, including the one that causes COVID-19.
Remdesivir works by interfering with the virus's ability to make copies of itself. This can help slow down the virus's spread in the body and give the immune system more time to fight it off.
Remdesivir is given intravenously through a drip, once a day, for 5 days or until you leave hospital.

Paxlovid (Nirmatrelvir-ritonavir) is a combination of two different drugs that work together to fight viruses.
Nirmatrelvir is like a blocker that stops the virus from getting into our cells. Ritonavir helps to make sure that nirmatrelvir stays in the body longer, so it can keep working to stop the virus entering our cells.
Nirmatrelvir-ritonavir is given as an oral tablet for 5 days.

The tables below outline the possible side effects for each treatment and how likely they are to occur.

Common (>10%)	More than 10 people out of every 100 people will report this side effect
Uncommon (1-10%)	1 to 10 people out of every 100 people will report this side effect
Rare (0.1-1%)	1 in 1,000 to 1 in 100 people will report this side effect
Very Rare (<0.1%)	less than 1 in 1,000 people will report this side effect

Domain A – Antiviral Drugs

Remdesivir

Side Effect	Likelihood	Comment
Infusion-related reaction	Rare	Generally mild but can be severe. This can happen due to the administration of intravenous medications.
Hypersensitivity	Rare	Generally mild but can be severe. This can happen due to the immune systems response to remdesivir or its components.
Headache	Common	Generally mild to moderate. This is potentially caused by the effects of remdesivir on the central nervous system.
Nausea	Common	Generally mild to moderate. This is potentially caused by the effects of remdesivir on the gastrointestinal tract.
Rash	Common	This can happen due to the immune systems response to remdesivir or its components. Usually self resolves and doesn’t require any specific treatment
Increased liver enzymes	Very Common	This can happen due to the effect of remdesivir on the liver. Usually self resolves and doesn’t require any specific treatment

Nirmatrelvir-Ritonavir (Paxlovid)

Side Effect	Likelihood	Comment
Diarrhoea, Vomiting	Common	Generally mild to moderate. This is potentially caused by the indirect effects of Paxlovid on the gastrointestinal tract.
Altered sense of taste, Headache	Common	Generally mild to moderate. This is potentially caused by the effects of Paxlovid on the central nervous system.
Muscle pain	Uncommon	Usually self resolves and doesn’t require any specific treatment. This can happen due to the immune systems response to Paxlovid or its components.
High blood pressure	Uncommon	Usually self resolves and doesn’t require any specific treatment.