Last updated 20 Aug 2020
Original Author: Dr Jacqui Bollmann, Independent Consultant Occupational Physician and Force Medical Adviser, South Yorkshire Police
Originally Reviewed by: Prof Paul Cullinan, Honorary Consultant in Respiratory Medicine, Royal Brompton & Harefield NHS Trust and Professor in Occupational and Environmental Respiratory Disease at the National Heart and Lung Institute, Imperial College London
Amended by: Dr Tony Williams, Consultant Occupational Physician
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Respiratory condition
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Vulnerability
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references
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| Asthma
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We have removed the text in relation to asthma as it conflicts with the data from the OpenSAFELY study, and does not reflect the good evidence for a gradient of relative risk with increasing age. | |
| Bronchiectasis
Severe, requiring nebulised treatments or FEV1 <50% MRC breathlessness score 3 or more Two or more exacerbations in past year requiring steroid or antibiotics Regular daily oral steroid Home oxygen therapy Non-invasive home ventilation or BiPAP |
Use clinical judgement that reflects the average age value for that person – likely to be significantly above the average age value | |
| Bronchiectasis
Mild, MRC 1, none of above criteria |
No evidence of increased vulnerability | |
| COPD
FEV1 <50% GOLD 3 or 4 classification MRC breathlessness score 3 or more Hospital admission for COPD in past Two or more exacerbations in past year requiring steroid or antibiotics Regular daily oral steroid Home oxygen therapy Non-invasive home ventilation or BiPAP |
Use clinical judgement that reflects the average age value for that person – likely to be significantly above the average age value | |
| COPD
GOLD 1 or 2 classification |
No evidence of increased vulnerability | |
| Cystic fibrosis: all | Emerging evidence for cystic fibrosis demonstrates that the highest risk is in those with other co-morbidities | https://www.blf.org.uk/support-for-you/coronavirus/what-is-social-shielding |
| Interstitial lung disease and pulmonary fibrosis
Limited by breathlessness MRC 3 or above Previous hospital admission for condition Two or more exacerbations or flare-ups in past year requiring steroids or antibiotics Regular daily oral steroid Home oxygen therapy FVC <80%, TLco <60% Pulmonary hypertension
Currently taking Azathioprine Cyclosporin Methotrexate Mycophenylate mofetil Nintedanib Pirfenidone Sirolimus Tacrolimus
Intravenous therapy in past six months with Cyclophosphamide Infliximab Rituximab |
Use clinical judgement that reflects the average age value for that person – likely to be significantly above the average age value | https://www.blf.org.uk/support-for-you/coronavirus/what-is-social-shielding
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| Interstitial lung disease and pulmonary fibrosis
MRC breathlessness score 2 and below, none of the above treatments |
Use clinical judgement that reflects the average age value for that person – likely to be below the average age value | |
| Lymphangioleiomyomatosis (LAM) | Very high or high | Likely to be at least high once a patient has presented clinically, and may well be advised to shield if at an advanced stage or if substantially immunosuppressed. |
| Other respiratory infection
Past TB |
May be increased | https://www.europeanlung.org/en/QA-covid-19
post-TB lung damage often puts you at a higher risk of picking up chest infections and so you might be at slightly higher risk of having a chest infection if you were infected with COVID-19 |
| Other respiratory infection
Current viral infection |
Unclear, may be increased | https://www.europeanlung.org/en/QA-covid-19
individuals can get Covid19 in the presence of other URTI – no data on whether the effect will be increased |
| Other respiratory infection
Past infection, recovered |
Low once well and after 7 days | https://www.europeanlung.org/en/QA-covid-19
Previous infections do not increase the risk of more severe infections in future unless the previous infections were due to other diseases (such as severe heart or lung conditions, diabetes or conditions or drugs that suppress the immune system) |
| Sarcoidosis
Stage III or IV MRC breathlessness score 3 or more Two or more exacerbations or flare-ups in past year requiring steroids or antibiotics Regular daily oral steroid Home oxygen therapy FVC <80%, TLco <60% Pulmonary hypertension Currently taking immunosuppresants |
Use clinical judgement that reflects the average age value for that person – likely to be significantly above the average age value | https://www.blf.org.uk/support-for-you/coronavirus/what-is-social-shielding
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| Sarcoidosis
Stage II bilateral hilar lymphadenopathy and infiltrates In remission for eighteen months |
Use clinical judgement that reflects the average age value for that person – likely to be below the average age value | |
| Sarcoidosis
Stage I bilateral hilar lymphadenopathy In remission for eighteen months Stage 0 (normal CXR) or I (bilateral hilar lymphadenopathy) Never required treatment |
Low | |
Risk of severe illness or death if contracts COVID-19. Read more
Likely to need hospitalisation if contracts COVID-19, with protracted illness and heavy NHS burden. Read more
Increased risk compared with healthy individual but should recover.
No greater risk than healthy individual.