Brit J Hosp Med
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Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. ⋯ Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.
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The National Institute for Health and Care Excellence guidelines advise stopping immunosuppressive drugs for confirmed or suspected COVID-19 patients with autoimmune and inflammatory disorders. This may not be in the patient's best interest, given the potential long-term consequences of not managing chronic conditions, and immunosuppression may even be protective in those affected with COVID-19.
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Rheumatology patients who are taking immunosuppressants are considered to be at 'high risk' from COVID-19, hence have been self-isolating or shielding. However, they may be protected from the features of hyperinflammation driven by a 'cytokine storm', so may have better clinical outcomes if infected. This editorial discusses whether it may not be necessary to advise these patients to shield.