2 Patients with new symptoms of COVID‑19
2.1 Advise all patients to contact their dedicated transplant programme helpline (rather than NHS 111) if they feel unwell to ensure their symptoms are appropriately assessed.
2.2 Be aware that patients having haematopoietic stem cell transplantation are immunocompromised and may have atypical presentations of COVID‑19. Also, symptoms of COVID‑19, neutropenic sepsis and viral pneumonitis may be difficult to differentiate at initial presentation.
2.3 If patients have fever (with or without respiratory symptoms), suspect neutropenic sepsis because this can be rapid and life-threatening, and 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.
2.4 If COVID‑19 is later diagnosed in a patient not isolated from admission or presentation, follow UK government guidance on management of exposed healthcare workers and patients in hospital settings.
2.5 If a patient not previously known or suspected to have COVID‑19 shows new symptoms suggestive of COVID‑19, 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.