Some patient groups are more at risk than others. Although there is little supporting data, the following groups should be considered as having higher risk of morbidity and mortality:
- Immunocompromised patients including haematology/oncology patients.
- Patients with chronic respiratory illness such as cystic fibrosis, bronchiectasis, prematurity or home ventilation.
- Patients taking immunomodulating medication e.g. those with rheumatological disease.
We recommend that patients at high risk of complications are rapidly assessed and, if they do not require immediate resuscitation, are admitted to the ward or other protective isolation area for work-up, to minimise exposure.
We advocate for age-appropriate negative pressure facilities, recognising that these may not always be available.
Some children may find respiratory precautions particularly challenging, such as those with autism spectrum disorder or other neurodevelopmental disorders. Although these children are not at higher risk in themselves, the process of isolation, swabbing and respiratory precautions may prove to be particularly challenging.
We recommend rapid assessment and disposition of children who may have difficulty tolerating respiratory precautions, especially those under school age or with special needs.