The U.K.’s National Institute for Health and Care Excellence (NICE) Thursday published three new rapid COVID-19 guidelines on treating patients with cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD) and certain dermatological conditions. Patients with CF should be supported in continuing all their usual self-care arrangements, NICE said. Since CF patients are extremely vulnerable to COVID-19, the guideline recommends several ways to provide care while minimizing face-to-face contact and hospital visits. The COPD guideline recommends that patients continue taking their regular inhaled and oral drugs, including corticosteroids. However, COPD patients who develop COVID-19 symptoms should not start a short course of corticosteroids or antibiotics, and they should not routinely start prophylactic antibiotics to reduce their risk from the coronavirus. COPD patients using noninvasive ventilation at home should be advised of precautions to take to protect others from potentially infectious aerosols from the ventilators. The guideline on dermatological conditions treated with drugs that affect the immune response recommends that patients with COVID-19 should continue topical treatments. In treating new skin conditions, doctors should consider using topical treatments rather than systemic ones. These patients shouldn’t suddenly stop taking oral corticosteroids. While they may continue to take hydroxychloroquine, mepacrine, dapsone and sulfasalazine, NICE said they should consider temporarily stopping all other oral immunosuppressive therapies, novel small-molecule immunosuppressants, biologics and monoclonal antibodies. The agency plans on issuing more COVID-19 guidelines, including ones for acute cardiac injury and the use of immunosuppressant drugs for gastrointestinal conditions. NICE is making the guidelines available internationally.

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