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Patients assessed to be at high risk of complications from coronavirus (COVID-19) will be added to the Shielded Patient List. Although this decision is made on a case by case basis, a set of criteria has been devised to determine whether a patient may be at high, moderate or low risk of complications.
Patients deemed to be at high risk of developing complications from COVID-19 include:
- solid organ transplant recipients
- people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD)
- people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as Severe combined immunodeficiency (SCID), homozygous sickle cell)
- people on immunosuppression therapies sufficient to significantly increase risk of infection
- people who have problems with their spleen, for example have had a splenectomy
- adults with Down’s syndrome
- adults on dialysis with kidney impairment (Stage 5 Chronic Kidney Disease)
- women who are pregnant with significant heart disease, congenital or acquired
- people with cancer who are undergoing active chemotherapy
- people with lung cancer who are undergoing radical radiotherapy
- people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
- people having immunotherapy or other continuing antibody treatments for cancer
- people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
- people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
In February 2021, people identified as being at high risk as a result of the COVID-19 Population Risk Assessment have also been included in the Shielded Patient List. You can find further information about this assessment here.
Children and young people at “high risk” from COVID-19 will continue to be identified based on the guidance published by the Royal College of Paediatrics and Child Health (RCPCH).
Some speciality organisations have developed decision-support tools to help identify patients. Please note that this is guidance, and ultimately the decision to add a person to the high risk category will be on a case by case basis.
Patients are at moderate risk of developing complications from coronavirus (COVID-19) where:
- They meet the criteria that make them eligible for the annual flu vaccination (except those aged 65 to 69 years old inclusive who have no other qualifying conditions).
- They do not meet the CMO criteria for the high risk group for COVID-19, including those identified by the COVID-19 Population Risk Assessment.
This includes patients aged 70 or older (regardless of medical conditions), or patients under 70 years old who:
- have chronic (long-term) respiratory disease, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
- have chronic heart disease, such as heart failure
- have chronic kidney disease (Stage 1 to 4)
- have chronic liver disease, such as hepatitis
- have a chronic neurological condition, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
- have diabetes
- have a weakened immune system caused by a medical condition or medications such as steroid tablets or chemotherapy
- are seriously overweight (a BMI of 40 or above)
- are pregnant.
For adults, this is usually anyone instructed to get a flu jab as an adult each year on medical grounds.
Patients are low risk if they are not in the moderate or high risk groups.