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Covid-19 Primary Care Resources


Interstitial Lung Disease



Shielding, and specific issues if unwell with Covid 19

This information is sourced from NHS London clinical networks and the British Thoracic Society (BTS):

Specific issues in case of Covid 19 infection:

This information is sourced from NHS London clinical networks:

If baseline saturations are available:

  • Mild deterioration would be defined as up to 2% below their baseline
  • Moderate deterioration would be defined as between 3-4% below their baseline
  • Severe deterioration would be defined as 5% or more below their baseline

Consider ceiling of care:

  • Many patients who have established pulmonary fibrosis, of any cause, will not do well with intubation and mechanical ventilation
  • Patients are likely to become hypoxic very quickly as they will not have much reserve
  • They will have often had advance care planning as part of their specialist care

Pirfenidone and nintedanib antifibrotic therapy can be safely paused for 4-8 weeks during illness. Do not stop long term prednisolone and consider increasing baseline doses. Mycophenolate, mofetil and azathioprine and other immune suppressive medication would normally be paused during significant infective illnesses and restarted two weeks after recovery

Shielding – guidance differs

This information is sourced from British Thoracic Society (BTS):

  • BTS noted an absence of some respiratory patient groups that should have been included specifically and named as high risk [in the CMO shielding criteria] including patients with Interstitial Lung Disease/Sarcoidosis
  • All ILD patients seen in both primary and secondary care should now be sent a shielding letter

This information is sourced from NHS London clinical networks:

  • Patients with interstitial lung disease should be following self-isolation guidance and if also on immune suppression consider extending this to the shielding approach