Patients may have received a letter identifying them as being at high risk of contracting Coronavirus. Please see below a list of problems which identifies patients as being in this high risk group:
- People with a solid organ transplant such as a kidney or liver transplant
- People with specific cancers
- People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- People having immunotherapy or other continuing antibody treatments for cancer
- People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
- People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.
- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD. See below.
- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
- People on immunosuppression therapies sufficient to significantly increase risk of infection
- People who are pregnant with significant congenital heart disease
- All patients on the following medications: Azathioprine, Mycophenolate (both types), Cyclosporine, Sirolimus, Tacrolimus.
- Patients with diabetes with HbA1c greater than 75, recent diabetic ketoacidosis or poor medication adherence;
- Patients with Chronic Obstructive Pulmonary Disease (COPD) who have required hospitalisation in the last 12 months or patients who have required 2 or more courses of steroids and/or antibiotics in the last 12 months;
- Patients with asthma with a history of hospitalisation in the last 12 months or ever been admitted to intensive care;
- Patients with significant heart failure which has required hospitalisation for their heart failure within the last 12 months;
- Patients with multiple long-term conditions;
- Patients who have had a splenectomy;
- Patients taking continuous oral corticosteroids of the equivalent of 20 mg of prednisolone or more for over 4 weeks;
- Patients taking immunosuppressive or immunomodulating medication such as cyclosporine, cyclophosphamide, azathioprine, leflunomide, methotrexate, mycophenolate. It is expected that patients taking these medications will be under a shared-care protocol with hospital specialist colleagues and a risk stratification approach should be taken. Advice can be sought from the relevant specialist. Guidance is available from the British Society of Rheumatology https://www.rheumatology.org.uk/news-policy/details/Covid19-Coronavirus-update-members
- Other patients that the general practitioner considers would be at high risk such as patients with severe dementia, cognitive impairment.
- https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19