The National Institute for Health and Care Excellence (NICE) has published its latest set of COVID-19 rapid guidelines.
They cover the management of patients with cystic fibrosis, COPD and dermatological conditions treated with drugs affecting the immune response.
The guideline on cystic fibrosis makes clear that patients should be supported to continue with all their usual self-care arrangements. It also explains that patients can still access cystic fibrosis transmembrane conductance regulator (CFTR) therapies under the NHS England policy statement for these drugs.
Given the severe capacity constraints because of managing the Covid-19 pandemic, the guideline recommends that the transition of young people to adult services should be deferred until the pressures associated with the COVID-19 pandemic have passed.
The guideline on COPD recommends that patients should continue taking their regular inhaled and oral medicines, including corticosteroids, in line with their individualised self-management plan to ensure their COPD is as stable as possible. This includes those with COVID-19, or suspected of having it. It also recommends that patients with COPD who are still smoking should be strongly encouraged to stop.
If they develop symptoms of COVID-19, the guidance advises that patients should not start a short course of oral corticosteroids and/or antibiotics. It also says they should not routinely start prophylactic antibiotics to reduce their risk from COVID-19.
The guideline on dermatological conditions treated with immunosuppressing drugs says that patients known or suspected to have COVID-19 should continue topical treatments, and that the use of topical rather than systemic treatments should be considered for any new skin conditions.
The guideline also advises that these patients should not suddenly stop taking oral corticosteroids. They can also continue to take hydroxychloroquine, chloroquine, mepacrine, dapsone and sulfasalazine, but consider temporarily stopping all other oral immunosuppressive therapies, novel small-molecule immunosuppressants, biological therapies and monoclonal antibodies.