Uveitis National Clinical Study Group: Immunosuppression and COVID-19 Update for Patients with uveitis and scleritis.

November 7th 2020

 

The government has set out national restrictions including the guidance for distancing for patients at moderate (clinically vulnerable) and the high risk (clinically extremely vulnerable) groups. Patients falling into the high risk group are receiving letters/ emails advising them to shield during lockdown.  

 

Advice during ‘lockdown' and beyond

 

- If you have received a letter informing you that you are in the high risk group, simply follow this advice. Your uveitis doctor may modify this advice during a consultation if this is appropriate.

 

- If you have been on cyclophosphamide within the last 6 months, you should shield for the duration of lockdown.

 

- If you are on immunosuppressant medications, low dose steroids (10mg or less) or both, we consider you to be in the moderate risk group and you do not need to shield. You should be able to be socially distanced at work if you are not able to work from home.

 

- There may be an increase in the risk from COVID-19 if you are on high dose steroids but short-term steroids can also be necessary to control eye inflammation when sight is at risk. 

 

Your doctor will perform a risk assessment with you if they think you might need high dose steroids and decide with you if you need to shield. If there are children at home who are going to school, we recognise that it is very difficult to shield. It may also affect the mental health of some patients who may feel very isolated.

 

- Do not stop your usual immunosuppression or steroids.

 

Update about the risks of immunosuppression for adults and children during COVID 19

 

Recent studies have shown that adult patients on immunosuppressant medication for chronic inflammatory diseases are not linked with worse COVID-19 infections or a greater risk of death. There are other risks factors which are important such as increasing age, heart disease and obesity. More details are available on these government pages

Children on immunosuppression are also at no greater risk of contracting COVID-19 or of being more sick than other children if they do get coronavirus. Children and young adults will continue to go to school, colleges and university. The advice for children is summarised on the CCA.org website.

Although a vaccine is not yet ready, we are optimistic that this is not far away. The new vaccine from the UK is designed so that it can be taken safely by patients on immunosuppression.

 

 

Resources for Uveitis and Scleritis Patients

Resources for emotional and mental wellbeing: https://www.mind.org.uk/information-support/coronavirus-and-your-wellbeing/#collapsec1fd1

 

 

Reliable resources for the UK are:

For parents and children:

 https://wordday.org/wp-content/uploads/2020/03/WORDday2020-CORONA-PReS-guidelines.mp4

 

Government Webpages about coronavirus and government advice for at risk groups:

https://www.gov.uk/coronavirus

https://www.nhs.uk/conditions/coronavirus-covid-19/

 

Higher Risk Groups:

https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/

 

Clinically extremely vulnerable group: 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

 

Hand Hygiene:

https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/