Manchester Uveitis Clinic, Manchester Royal Eye Hospital
Novel Coronavirus (COVID-19):
Advice for patients using medication by mouth or by injection, to treat uveitis
Last updated 20/03/2020
COVID-19 is a new illness that can affect your lungs and airways. It is caused by a virus called coronavirus.
It is known that infections of any sort can be more serious if your immune system is not working properly. Some treatments for uveitis cause this immune suppression. Patients taking immunosuppression medications are not at increased risk of catching coronavirus but may be more severely affected if they do get it. Steroids (Prednisolone), immunosuppression (agents listed below) and biologic therapies (listed below) affect the function of the immune system and if you are taking these for uveitis (and/or other conditions) your immune system function will be suppressed to some extent. The level of immunosuppression depends on the dose, combination of treatments and any other health conditions. The following medications are all immunosuppressant treatment:
Azathioprine
Adalimumab
Ciclosporin
Infliximab
Methotrexate
Mycophenolate mofetil
Tacrolimus
You may also be immune suppressed if you have been treated in the last year with cyclophosphamide or rituximab.
Advice on medication:
We have taken note of all Government advice, and instructions given by the Medical Director of this Hospital Trust. We have also discussed this specific issue with physician colleagues who also use immunosuppression, and have researched the medical literature.
Having taken these steps, our current advice is that if you are immune suppressed, you should not stop your medication. If you do so, there is a significant possibility that your eye inflammation will worsen, and any steps then taken to control it may lead to greater problems. The risk from this medication in relation to Coronavirus is small.
Information on coronavirus:
Up to date information from the UK Government can be found online on the following websites:
https://www.nhs.uk/conditions/coronavirus-covid-19/
https://publichealthmatters.blog.gov.uk/2020/01/23/wuhan-novel-coronavirus-what-you-need-to-know/
If you are immunosuppressed it is important to take precautions to reduce the risk of infection and we recommend you regularly review the guidance on the above Government websites.
Symptoms of coronavirus
The symptoms of coronavirus are:
- a new continous cough
- a high temperature
- shortness of breath
But these symptoms do not necessarily mean you have the illness.The symptoms are similar to other illnesses that are much more common, such as cold and flu.
How coronavirus is spread
Because it’s a new illness, we do not know exactly how coronavirus spreads from person to person.
Similar viruses are spread in cough droplets.
It’s very unlikely it can be spread through things like packages or food.
How to avoid catching or spreading coronavirus
Do
- wash your hands with soap and water often – do this for at least 20 seconds
- always wash your hands when you get home or into work
- use hand sanitiser gel if soap and water are not available
- cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- put used tissues in the bin straight away and wash your hands afterwards
- try to avoid close contact with people who are unwell
Don’t
- do not touch your eyes, nose or mouth if your hands are not clean
Medical Help
NHS 111 has an online coronavirus service that advises what to do if you are unwell and when to contact NHS 111 telephone service. If you are taking immunsouppression and have symptoms of coronavirus we recommend you contact NHS 111 immediatedly for advice.
We recommend that if you do call NHS 111 that you have a list of your medications and inform 111 of these.
Do not attend Manchester Royal Eye Hospital if you have symptoms or if you have tested positive for novel Coronavirus
If you think that you have symptoms suggestive of Coronavirus and are self-isolating at home or if you have been tested and found to be positive, you should not attend any Manchester Royal Eye Hospital outpatient appointments or the Eye Emergency Department until you are fully recovered.
If you have symptoms and require medical advice please access NHS111 online and telephone NHS111 in the first instance. For advice regarding your uveitis condition and treatment please contact our team.
In these circumstances if you are due to have an appointment in the Uveitis Clinic please contact the Uveitis secretarial team and a member of the medical team (Doctor or Nurse Practitioner) can undertake a telephone consultation, and arrangements can be made for prescriptions of medicines.
Should patients who become infected cease their medication?
If you develop symptoms of an infection, established practice should be followed and immunosuppressive therapy (tablets (listed above) or injections) paused for the duration of the infection and until you feel better, but this must be in consultation with your medical team. However, do not stop steroid (Prednisolone) therapy abruptly and seek advice.
Contact the Uveitis Service
Please telephone the uveitis team secretaries if you require medical advice from the uveitis team:
Contact numbers are: 0161 276 5628 , 0161 276 5565 and 0161 701 4838
Alternatively our uveitis nurse practitioner, Gigi Binny on 0161 276 6841 can be contacted for advice and medication queries. If you are unable to reach Gigi please leave a voicemail and you will be contacted as soon as possible.
Please do not email the secretaries or doctors directly – this is not a secure route of communication and there could be a delay in response.