COVID-19 is no worse in immunocompromised children, says NICE

Doctors should reassure parents and carers of children who are immunocompromised that immunosuppression does not seem to increase the risk of severe COVID-19, the UK National Institute for Health and Care Excellence (NICE) advises in a rapid guideline.

“Covid-19 usually causes a mild, self-limiting illness in children and young people, even in those who are immunocompromised,” NICE says.

Children and teenagers who are immunocompromised and their carers may be feeling particularly anxious and fearful about covid-19, so it is important they are involved in decision making as much as possible, NICE advises. Doctors should also support patients’ and carers’ mental wellbeing through communication and by signposting to charities and support groups.

The guideline says that patients should not avoid their usual appointments unless they have been told to and should continue with their usual treatment. However, face-to-face contact should be reduced where safely possible and alternative approaches such as telephone, video, or email consultations used instead.

When deciding whether to start treatments that affect the immune system, doctors should discuss the risks and benefits with the patient and their carers. If it is safe to delay treatment then watchful waiting should be undertaken.

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Source: BMJ, 1 May 2020