New COVID-19 guidelines for severe asthma, pneumonia, rheumatological disorders and symptom management published by NICE

The guidelines cover the management of severe asthma, pneumonia, rheumatological autoimmune, inflammatory and metabolic bone disorders as well as management of COVID-19 symptoms in the community.

4 new ‘rapid guidelines’ have been published by NICE on the active management of patients suspected or confirmed of having been infected with COVID-19.

The guidelines have also been designed to ‘maximise the safety’ of patients whilst enabling services to use NHS resources most efficiently.

Severe asthma

NICE guidelines for those with severe asthma are as follows:

‘The guideline on severe asthma says that people should continue to take their treatment as prescribed and only attend essential appointments alone, if possible, to minimize the risk of infection.’

‘The guideline recommends that patients should be advised to regularly clean equipment such as face masks and mouth pieces, and that they should not share their inhalers and devices with anyone else.’

See more here: COVID-19 rapid guideline: severe asthma


NICE guidelines on pneumonia in adults are as follows:

‘As COVID-19 becomes more prevalent in the community, pneumonia is more likely to be caused by the COVID-19 virus than bacteria.’

‘Viral pneumonia will not respond to the use of antibiotics therefore they should only be offered if bacteria are the likely cause, it is unclear whether the cause is bacterial or viral and symptoms are more concerning or the person is at high risk of developing complications.’

‘People should seek medical help without delay if their symptoms don’t improve or worsen rapidly, whether they have been given an antibiotic or not.’

‘When possible, clinicians should discuss the risks, benefits and possible likely outcomes of treatment options with patients with COVID-19, and their families and carers, so that they can express their preferences about their treatment.’

See more here: COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community

Rheumatological autoimmune inflammatory & metabolic bone disorders

NICE guidelines on Rheumatological autoimmune inflammatory & metabolic bone disorders are as follows:

‘The guideline on rheumatological autoimmune, inflammatory and metabolic bone disorders says that patients with COVID-19 should not suddenly stop taking their medication but should seek advice on which medicines to continue and which to temporarily stop.’

‘If they feel unwell, patients should contact their rheumatology team about any rheumatological medicines issues or if their condition worsens contact NHS 111 for advice on COVID-19. Healthcare professionals should use NHS England’s COVID-19 clinical guide when deciding what treatments are appropriate.’

See more here: COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders:

Managing symptoms in the community

NICE guidelines on managing symptoms in the community including end of life care are as follows:

‘The guideline on managing symptoms provides advice to health professionals on the management of cough, fever, breathlessness and anxiety, delirium and agitation in those with COVID-19.’ 

‘It includes approaches for managing these symptoms such as considering the use of paracetamol in people with fever.’

‘People are advised to first treat a mild cough with simple measures and should also avoid lying on their back as this can make coughing, which helps clear the lungs, more difficult.’

‘If the cough is more severe and distressing, codeine linctus, codeine phosphate tablets or morphine sulphate oral solution could be considered for short-term use.’

‘Further guidelines will be announced in due course but are likely to include: COPD; Cystic fibrosis and dermatological conditions in people receiving immunotherapy.’

‘NICE will publish new guidelines each based on the priorities for patients and the NHS.’

‘NICE will also make the guidelines internationally available so that health systems around the world can see the approach the UK is taking.’

‘The guidelines are being produced in collaboration with NHS England/Improvement and a cross-specialty clinical group, supported by the specialist societies and Royal Colleges.’

See more here: COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community