The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of April 2020. This month there are seven rapid guideline and evidence reviews and one evidence summary related to COVID-19 that impact upon primary care.
The Acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19 evidence summary has been published. This review found no evidence from published scientific studies to determine whether acute use of NSAIDs is related to increased risk of developing COVID-19 or increased risk of a more severe illness. It is noted that NSAIDs may either have no effect on, or worsen, long-term outcomes, possibly by masking symptoms of worsening acute respiratory tract infection. For now, paracetamol use to control fever symptoms would seem prudent in keeping with previous recommendations.
The COVID-19 rapid guideline: community-based care of patients with chronic obstructive pulmonary disease (COPD) guideline has been published. It aims to maximise the safety of patients with chronic obstructive pulmonary disease (COPD) during the COVID-19 pandemic, while protecting staff from infection. It will also enable services to make the best use of NHS resources.
The COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community guideline has been published. It aims to provide recommendations for managing COVID‑19 symptoms for patients in the community, including at the end of life. It also includes recommendations about managing medicines for these patients, and protecting staff from infection.
The COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community guideline has been published. It aims to ensure the best treatment for adults with suspected or confirmed pneumonia in the community during the COVID-19 pandemic. It will also enable services to make the best use of NHS resources.
There are also COVID-19 rapid guidelines in the following areas that broadly apply to secondary care, but the recommendations to minimise face-to-face contact to reduce the risk of infection by using electronic means of communication, consultation and prescribing are pertinent to primary care as well.
- Severe asthma
- Rheumatological autoimmune, inflammatory and metabolic bone disorders
- Dermatological conditions treated with drugs affecting the immune response
- Cystic fibrosis
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.