COVID-19 and PSC
COVID-19 and PSC
Acute cholangitis planning
Social distancing
News and government announcements indicate that COVID-19 (coronavirus) is a public health pandemic. We, the public, are being asked to take steps to reduce the transmission of the virus by practicing social distancing, especially certain groups of people, including individuals with chronic liver disease. PSC is a chronic liver disease.
People who have received a liver transplant and are on immunosuppression medication (all patients who have had a transplant for PSC take immunosuppression medication) are considered at higher risk and will be asked to take even stricter measures in the next few days. We understand that you will be contacted directly with advice on the more stringent measures you should take in order to keep yourself and others safe. For now, they advise that you rigorously follow the social distancing advice in full.
Acute cholangitis - planning ahead
We advise that you take steps now to ensure you have access to treatment for acute cholangitis over the coming weeks so that you can avoid A&E if possible in the first instance. There is a real danger that A&E departments will be overrun as well as the increased risk of COVID-19 infection while in A&E.
We are asking people with PSC to contact their GP now to ask for:
- A course of antibiotics to keep at home (such as ciprofloxacin, co-amoxiclav or co-trimoxazole). The standard duration for course of antibiotics for acute cholangitis in PSC is 2-3 weeks.
- A blood test request to be kept on the system for you, to include:
- Full blood count (FBC)
- Urea and electrolytes (U&E)
- Liver blood tests (LFTs)
This may not be possible for all areas. Please let us know if you have problems arranging this or contact your consultant for advice. We suggest the best way to make these arrangements is to ask for a telephone consultation with your GP. Understandably, GPs are under a great deal of pressure at the moment, so there may be a delay before you get a response.
It is also worth having a thermometer at home right now.
If you think you have cholangitis
If you get symptoms of cholangitis, start your antibiotics. (Your GP may advise you to arrange a telephone consultation with them before you start taking them). If you do not start to improve within 48 hours of starting them, contact NHS111 for advice. If it is cholangitis that is resistant to antibiotics, COVID-19 or something else, you will need medical attention.
Post transplant patients
The principle, if you have post transplant cholangitis, is the same, but it is important that other causes are excluded. If you are post transplant and think you have cholangitis, contact your transplant unit first as would be normal practice now. You can then set up support form your GP following their advice.
Revisions
18 March 2020 - Added paragraph 'Post transplant patients'