National Institute for Health and Clinical Excellence (NICE)
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NICE publishes single guideline for managing COVID-19

One year on from the first national lockdown, NICE yesterday (23 March) published a single guideline for the management of COVID-19 in children and adults.

Doctors treating patients with COVID-19

In response to ongoing developments throughout the pandemic, NICE has produced numerous rapid COVID-19 guidelines to help healthcare workers respond to the ongoing pandemic. Feedback has indicated that users would now find it useful for all essential information about managing COVID-19 to be included in a single piece of guidance.

The guideline was developed in the MAGICapp platform, a global system that promotes evidence sharing from different guideline creators, therefore increasing the speed at which guidance can be developed and the ease with which it can be updated.

Dr Paul Chrisp, Director of the Centre for Guidelines at NICE, yesterday said:

“This new living guideline is the latest development in our ongoing response to the COVID-19 pandemic, and we hope its publication will support healthcare professionals caring for patients unwell with COVID-19.

“The pandemic has driven new collaborative and international ways of working, and by sharing high-quality evidence with our colleagues around the world we have been able to develop this guidance more quickly. By keeping abreast with the latest evidence, we hope to identify which guidance needs updating more efficiently.”

The guideline covers the management of clinically or lab-diagnosed COVID-19 for children, young people and adults across all care settings. It lists the key symptoms of COVID-19 for identifying patients with severe illness, including confusion, reduced oxygen levels, and shortness of breath.

In addition, the guideline includes updated recommendations on two treatment options for COVID-19. An update to the previously published evidence summary, guidance suggests that remdesivir should now be considered for adults and children over the age of 12 who are receiving oxygen in hospital, but who are not on advanced respiratory support. An update to the earlier recommendation on heparins (which prevent the formation of blood clots) also means that these medications can be considered as treatment options for some COVID-19 patients. 

The guideline reiterates advice that patients’ individual wishes around treatment options and advance care plans should be discussed and documented clearly and used to inform care. If patients do not have advance care plans they should be given the opportunity to express their preferences. As previously recommended by NICE, when planning care healthcare professionals should not use tools such as the Clinical Frailty Scale for younger patients, or people with long-term stable disabilities such as cerebral palsy, learning difficulties or autism.

The MAGICapp platform is already being used by the WHO and the Australian National Taskforce for COVID-19, and evidence from Australia has supported the development of this guideline. However, the new guideline is wholly a NICE product and can be searched for and accessed via the NICE website.

The guideline can be viewed here.


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