COVID-19: NICE issues rapid guidelines

  • Tim Locke, Medscape.com
  • NICE

  • UK Medical News
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The National Institute for Health and Care Excellence (NICE) has published its first three rapid COVID-19 guidelines.

They cover hard choices around a patient's chances of recovery in critical care, cancer patients, and dialysis.

Critical Care NICE guideline [NG159]

All patients admitted to hospital should be assessed for frailty irrespective of COVID-19 status.

Risks and benefits and likely outcomes should be discussed with patients, carers or advocates and families using decision support tools (where available) so that they can make informed decisions about their treatment wherever possible.

For patients with confirmed COVID-19, decisions about critical care admission should be made on the basis of medical benefit and should take into account the likelihood that the person will recover to an outcome that is acceptable to them and within a period of time consistent with the diagnosis.

Systemic Cancer Treatments NICE guideline [NG161]

Where decisions need to be made about prioritising patients for treatment, these need to take into account the level of  immunosuppression  associated with individual treatments and cancer types, and any other patient-specific risk factors. They should also balance the risk from cancer not being treated optimally versus the risk of becoming seriously ill if they contract COVID-19 because of immunosuppression.

Where changes need to be made to usual care because of system pressures, consideration should be given to delivering treatment in different and less immunosuppressive regimens, different locations, or via another route of administration.

Dialysis NICE guideline [NG160]

Patients with suspected COVID-19 should be assessed to see whether dialysis could be delayed until their COVID-19 status is known. 

NICE also recommends that outpatient transport services should get patients to their dialysis as scheduled to avoid their condition deteriorating.

It should also be ensured that appropriate transport services are available by finding out what current transport providers are prepared to provide, and whether there are alternative providers if the current providers will not transport patients infected with COVID-19.

Adapted from Medscape UK.