This guideline advises on how to maximise the safety of immunocompromised children and young people during the COVID-19 pandemic.

Background

The National Institute for Health and Care Excellence (NICE) has produced a COVID-19 rapid guideline: children and young people who are immunocompromised; it covers those aged 17 and under, but may also be relevant for newborn babies under 72 hours, and 18 to 24 year olds using healthcare services. The guidance aims to maximise the safety this patient cohort, protect staff from infection, and enable services to make the best use of NHS resources.

Children and young people who are immunocompromised include those with: primary immunodeficiencies, secondary or acquired immunodeficiencies because of their condition or because of immunosuppressive treatment, chronic disease associated with immune dysfunction (such as organ dysfunction or failure or severe inflammatory disease).

Provides advice on managing the underlying condition in patients not known to have COVID-19; for example, management of: patients who are not yet taking medicines that affect the immune system but who may require them; patients who are already taking medicines that affect the immune response; monitoring of patients stabilised on treatment.

Provides advice on managing the underlying condition in patients suspected of having COVID-19; for example, patients taking medicines that affect the immune response might have atypical presentations of COVID 19 (e.g. those taking prednisolone may not develop a fever); when deciding about whether to stop usual treatment when a patient has symptoms of COVID 19, contact the specialist team for urgent advice before stopping any medicines.

Advises on modifications to usual care, including the supply of medicines:

  • Plan how to manage any disruption to normal routes for supplying medicines, such as using homecare medicines delivery services.
  • Prescribe usual quantities of medicines to meet the patient’s clinical needs. Prescribing larger quantities of medicines puts the supply chain at risk.
  • Provide repeat prescriptions of oral medicines or other at-home treatments without patients needing to attend hospital.