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Covid-19 Primary Care Resources


Who should shield, and precautions for all patients with splenectomy during the pandemic

This information is sourced from NHS Digital:

  • There has been some confusion regarding the inclusion of splenectomy on the Shielded Patient List (SPL)
  • Splenectomy codes were included in the national search criteria on a precautionary basis, because splenectomy may be associated with immunological function
  • GPs are able to add or remove people from the SPL based on more detailed local records, or according to their clinical judgement, specialist advice or knowledge of people s specific circumstances
  • The Government is reviewing shielding policy
  • Until this review is concluded, no further clinical guidance will be issued, and the criteria will remain unchanged
  • The 6 May BSH guidance identifying the patients that they consider to be clinically extremely vulnerable has not been formally issued to GPs due to the current shielding policy review

This information is sourced from the British Society for Haematology (BSH):

There is no evidence that the lack of a spleen or part of a spleen or a non -functioning spleen on its own renders patients at higher risk of Covid-19

Recommendations for shielding will therefore depend on the underlying cause for splenectomy or asplenia and any associated comorbidities and treatments

Patients who do not require shielding

  • Splenectomy for trauma
  • Thalassaemia or other inherited red cell disorders with splenectomy but without significant iron overload or comorbidities
  • Splenectomy for autoimmune disorders but not currently taking immunosuppressive treatment and not on SPL due to underlying disease.

BSH recommendations for all splenectomy patients

  • Ensure they are up to date with their vaccinations
    Patients taking regular prophylactic antibiotics should be encouraged to continue
  • Those who are not taking antibiotics should have a supply at home to take if unwell and instructed to do so by a clinician
  • All patients reporting a new fever should be evaluated for bacterial as well as viral infection