4 Patients with symptoms of COVID-19 at presentation

4 Patients with symptoms of COVID-19 at presentation

4.1 Assess and triage all patients to check if they could have COVID‑19, or if they have been in contact with someone who could have COVID‑19.

4.2 If a patient not previously known or suspected to have COVID‑19 shows symptoms on presentation, the general advice is to follow UK government guidance on investigation and initial clinical management of possible cases. This includes information on testing and isolating patients.

4.3 Be aware that patients having radiotherapy for certain cancers may be immunosuppressed and may have atypical presentations of COVID‑19. For patients having systemic anticancer treatment, see the NICE COVID-19 guideline on delivery of systemic anticancer treatments.

4.4 For patients having radiotherapy who are immunosuppressed and have a fever (with or without respiratory symptoms), suspect neutropenic sepsis. Follow the NICE guideline on neutropenic sepsis, which recommends:

  • referring patients with suspected neutropenic sepsis immediately for assessment in secondary or tertiary care

  • treating suspected neutropenic sepsis as an acute medical emergency and offering empiric antibiotic therapy immediately.

4.5 If COVID‑19 is later diagnosed in someone not isolated from admission or presentation, follow UK government guidance on management of exposed staff and patients in health and social care settings. [amended 22 May 2020]