A continually updated synthesis of all relevant guidance for GPs on managing acute Covid
This information is sourced from NHS London clinical networks, the BMJ, the Centre for Evidence Based Medicine (CEBM), NHSE, the Primary Care Diabetes Society (PCDS), NICE and NHSEI:
Review a patient’s notes before calling them
Consider conditions/medications which put someone at increased risk for serious illness or which need active management during their acute illness with Covid:
Screen for symptoms of Covid-19 infection and severity of illness
Focus on change. A clear story of deterioration is more important than whether the patient currently feels short of breath
Ask date of first symptoms (Covid-19 can produce rapid deterioration in respiratory function, especially in the second week)
Suggested questions to identify people with Covid-19 with the most severe illness:
- ‘How is your breathing today?’
- ‘Do you have an oximeter at home or have you noticed any blue discolouration of your lips?’
- ‘Are you more breathless than usual on walking or climbing stairs?’
- ‘When was the last time you went to the toilet and passed urine?’
Serious differential diagnoses such as bacterial pneumonia, meningitis, or sepsis should be considered
Check that patients eligible for antibody or antiviral treatments have been contacted by their local CMDU within 24 hours of a positive PCR test
If a pregnant woman records pulse oximeter readings of 94% or less they should be advised to attend their hospital immediately or call 999
Covid-19 can trigger new-onset diabetes and remain vigilant for symptoms of new-onset type 1 diabetes, particularly in children and young people who are unwell: Consider the 4Ts – Toilet, Thirsty, Tiredness, Thinner
Categorise symptoms and assess risk for patients with likely Covid 19
Written by Dr Poppy Freeman
