Pernicious anaemia treatment during COVID-19
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Guidelines on Pernicious Anaemia during COVID-19
How should my management of vitamin B12 deficiency vary when considering the possibility of COVID-19?
Non-dietary vitamin B12 deficiency
Discuss the need for intramuscular (IM) hydroxocobalamin with each person.
Ask people who require IM hydroxocobalamin COVID-19 screening questions before they attend GP surgeries.
Explore alternatives to attending GP surgeries for administration, such as local pharmacies or home administration by district nurses.
Offer oral cyancobalamin 1 mg per day as an alternative until regular IM hydroxocobalamin can be resumed — aim for the shortest possible break from regular injections.
Advise people to monitor their symptoms and contact their GP if they begin to experience neurological or neuropsychiatric symptoms, such as pins and needles, numbness, problems with memory or concentration, or irritability.
People who are already self-administering IM hydroxocobalamin should continue to do so.
Switching to self-administration during the COVID-19 pandemic is not recommended as instruction is likely to be difficult.
BSH guidance on B12 supplements during COVID pandemic
Non-dietary vitamin B12 deficiency
(e.g. pernicious anaemia, prior gastrectomy, bariatric surgery, achlorhydria, pancreatic insufficiency, short bowel syndrome, bacterial overgrowth, inflammatory bowel disease)
NICE Clinical Knowledge Summary 2019: administer hydroxocobalamin 1 mg intramuscularly every 2–3 months for life
British Society for Haematology advice during the COVID-19 pandemic for patients
established on intramuscular hydroxocobalamin:
The need for intramuscular (IM) hydroxocobalamin should be discussed with each patient individually. We recommend that screening questions for COVID-19 infection are asked before patients attend their GP surgeries. Alternatives to attending the GP surgery such as local pharmacies or home administration by district nurses should be explored.
As an alternative, oral cyanocobalamin can be offered at a dose of 1 mg per day until regular IM hydroxocobalamin can be resumed, i.e. once GP surgeries are able to do so safely, aiming to have a shortest possible break from regular injections.
Patients should be advised to monitor their symptoms and should contact their GP if they begin to experience neurological or neuropsychiatric symptoms such as pins and needles, numbness, problem with memory or concentration or irritability.
Patients who are already self-administering IM hydroxocobalamin should continue to do so but we do not recommend a patient switching to self-administration during the COVID-19 pandemic since instruction is likely to be difficult
Articles about Pernicious Anaemia during COVID-19
News articles about Pernicious Anaemia during COVID-19
Different Guidelines on treating Pernicious Anaemia We are aware that too many Primary Care Practices have told patients that due to the current COVID-19 pandemic, patients’ B12 injections have been stopped. We are also aware that there are between six and eight...
The last two weeks have been a very testing time for the society. This is because various professional bodies have issued Guidelines to doctors and other health professionals on how to deal with the unfolding Covid-19 pandemic. The British Society for Haematology...
This society is aware that the current Covid-19 pandemic is putting unprecedented demands on the NHS and that medical professionals at all levels are working hard…
General information about Pernicious Anaemia
For people with no neurological involvement: Initially administer hydroxocobalamin 1 mg intramuscularly three times a week for 2 weeks. Maintenance dose: hydroxocobalamin 1 mg intramuscularly every 2–3 months for life.