Clinical guidelines

COVID-19 assessment, treatment and management

• COVID-19 Clinical Screening Assessment Tool  (PDF 176 kB)
  A statewide COVID-19 Clinical Screening Assessment tool has been developed with the intent to enable Hospital and Health Services (HHSs) to appropriately assess the suitability for COVID-19 screening.
• National Covid-19 Clinical Evidence Taskforce flowcharts and guidance
• Paediatric COVID-19 management guidelines
  The following clinical guidelines have been developed by Children’s Health Queensland for the management of children with acute SARS-CoV-2 infection and/or Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19 (PIMS-TS).
  • CHQ-GDL-63400 Paediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19 (PDF 264 kB)
  • CHQ-GDL-63327 The management and treatment of children with acute SARS-CoV-2 infection (COVID-19) (PDF 925 kB)
• Guiding statement for impact of COVID-19 on rehabilitation services
  The purpose of this document is to highlight potential impacts the COVID-19 pandemic may have on people accessing timely rehabilitation assessment and treatment during the pandemic, and accessing rehabilitation services post COVID-19 infection, including longer-term post- COVID-19 Condition (‘Long COVID’) management.

COVID-19 therapies

COVID-19 Treatment Guidelines for severe and critical disease (hospitalised Adults) (PDF 352 kB)
This document has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with guidance in the assessment and management of hospitalised patients with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates.

COVID-19 Treatment Guidelines for mild to moderate disease (Adults) (PDF 440 kB)
This document has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with guidance in the management of patients with mild to moderate COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates.

Decision pathway for drug treatment of mild to moderate COVID-19 (PDF 120 kB)

• COVID-19 Therapeutic Drugs Patient Consent Form – adult  (PDF 193 kB)
  This document is designed to assist clinicians to document formal written consent prior to treatment.
• COVID-19 Therapeutic Drugs Patient Consent Form – paediatrics / young person (PDF 200 kB)
  This document is designed to assist clinicians to document formal written consent from a young person’s parent/caregiver prior to treatment.

Casirivimab and imdevimab

• Casirivimab and imdevimab prescribing guideline (PDF 467 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of casirivimab and imdevimab in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates
• Casirivimab and imdevimab (Ronapreve) patient information (PDF 195 kB)
• Casirivimab and imdevimab (Ronapreve) Informed consent: patient information (PDF 225 kB)
• Request to Access Casirivimab and imdevimab forms
  Access to molnupiravir is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. The forms have been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after administration.
  • Adults – For post-exposure prophylaxis (PEP) of COVID-19 (PDF 242 kB)
  • Adults – For treatment of mild to moderate disease in non-hospitalised patients (PDF 240 kB)
  • Adults High Dose – For treatment of moderate-severe-critical disease in hospitalised patients (PDF 201 kB)
  • Children’s Health – For post-exposure prophylaxis (PEP) of COVID-19 in paediatric patients (PDF 215 kB)
  • Children’s Health – For treatment of mild-moderate COVID-19 in paediatric patients (PDF 207 kB)
  • Children’s Health – For treatment of moderate-critical COVID-19 in paediatric patients (PDF 204 kB)

Molnupiravir

• Molnupiravir prescribing guideline (PDF 359 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of molnupiravir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates
• Molnupiravir patient information (PDF 120 kB)
• Molnupiravir Informed consent: patient information (PDF 372 kB)
• Molnupiravir forms
  • Molnupiravir forms are no longer required to be submitted to CTWG@health.qld.gov.au as per the molnupiravir prescribing guideline.

Nirmatrelvir plus ritonavir (Paxlovid®)

• Nirmatrelvir plus ritonavir prescribing guideline (PDF 890 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of nirmatrelvir plus ritonavir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates
• Nirmatrelvir plus ritonavir patient information (PDF 141 kB)
• Nirmatrelvir plus ritonavir Informed consent: patient information (PDF 485 kB)
• Nirmatrelvir plus ritonavir forms
  • Nirmatrelvir plus ritonavir forms are no longer required to be submitted to CTWG@health.qld.gov.au as per the Nirmatrelvir plus ritonavir prescribing guideline.

Remdesivir

• Remdesivir prescribing guideline (PDF 464 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of remdesivir in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates
• Remdesivir patient information (PDF 127 kB)
• Remdesivir Informed consent: patient information (PDF 274 kB)
• Remdesivir forms
  Access to remdesivir is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. This form has been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after commencement.
  • Request to Access Remdesivir Form - Moderate disease requiring oxygen (Adults) (PDF 194 kB)
  • Request to Access Remdesivir Form – Mild-moderate disease (Adults) (PDF 245 kB)

Sotrovimab

• Sotrovimab prescribing guideline  (PDF 514 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of sotrovimab in patients diagnosed with COVID-19. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates.
• Sotrovimab (Xevudy®) patient information (PDF 158 kB)
• Sotrovimab (Xevudy®) Informed consent: patient information (PDF 252 kB)
• Sotrovimab (Xevudy®) Patient Letter (PDF 205 kB)
  This fillable letter template has been designed to provide patients with a record documenting the date and location of their infusion and provides advice around the timing of any subsequent COVID-19 vaccinations
• Sotrovimab forms
  Access to sotrovimab is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. The forms have been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after administration.
  • Request to Access Sotrovimab Form - Adults (PDF 242 kB)
  • Sotrovimab Notification form - Paediatric (PDF 162 kB)

Tixagevimab plus cilgavimab (Evusheld®)

• Tixagevimab plus cilgavimab (Evusheld®) prescribing guideline (PDF 889 kB)
  This guideline has been developed by the Queensland Health COVID-19 Therapeutics Working Group (CTWG) to provide clinicians with information and guidance around the use of tixagevimab plus cilgavimab. These are living guidelines and will be updated frequently as new evidence emerges. Please refer to the version control table at the end of the document for information concerning updates
• Tixagevimab plus cilgavimab (Evusheld®) Informed consent: patient information (PDF 193 kB)
• Tixagevimab plus cilgavimab forms
  Access to tixagevimab plus cilgavimab is regulated via the National Medical Stockpile (NMS). States are required to report usage, including eligibility criteria and outcomes to the NMS. The forms have been developed to facilitate reporting and should be submitted for each patient via email to CTWG@health.qld.gov.au as soon as practicable after administration.
  • Request to Access Tixagevimab plus cilgavimab Evusheld) Form – Adults (PDF 186 kB)
  • Request to Access Tixagevimab plus cilgavimab Evusheld) Form – Paediatric patients (PDF 663 kB)
  • Serology data for tixagevimab and cilgavimab (Evusheld®) (PDF 995 kB)
  • 30 Day tixagevimab and cilgavimab (Evusheld®) Outcome Data (PDF 996 kB)

Note: Prescribing hydroxychloroquine

Under the Medicines and Poisons (Medicines) Regulation 2021, a prescription for hydroxychloroquine is not lawful unless written by an authorised prescriber.

Prescribers are authorised to prescribe hydroxychloroquine if:

• they are one of the following specialist practitioners: dermatologist, emergency medicine physician, haematologist, immunologist, infectious disease  physician, intensive care physician, nephrologist, paediatrician, rheumatologist, specialist physician in general medicine, a dentist who is a specialist registrant in oral medicine; or
• they are a medical practitioner or nurse practitioner who is continuing treatment with hydroxychloroquine that was initiated by one of these specialist  practitioners.

Medical practitioners and nurse practitioners who are continuing treatment with hydroxychloroquine must mark the prescription with the words ‘Continuing treatment’.

For information on TGA-approved medicines for COVID-19 please visit the TGA website. Further advice to guide their use in Queensland will be provided soon.

Maternity and neonatal

COVID-19 Guidance for maternity and neonatal services
This site refers to the Maternity and Neonatal Clinical Guidelines page and contains information specific to the care of mothers and babies during the COVID-19 pandemic including flowcharts for neonates of suspected or confirmed COVID-19 mothers, operational frameworks for COVID-19 maternity and neonatal services as well as videos and consumer information.

Paediatric care and advice

Preliminary evidence suggests children have a lower susceptibility to SARS-CoV-2 than adults, play a lesser role in transmission, and have a much lower risk of severe infection.

Children, adolescents, and young adults with underlying medical conditions are an exception, with some studies showing that these patients have an increased likelihood of developing severe disease and complications when infected with SARS-CoV-2. However, these studies do not reflect the epidemiology related to the more recently emerged variants such as the Delta variant and the Omicron variant of concern.

View the COVID-19 in children and adolescents: vaccines, transmission at school and disease outcomes webinar from the Centre for Immunisation Research and Surveillance which provides a summary of COVID-19 in children as well as the benefits of vaccination.

The following resources are designed to support health services and healthcare providers in managing COVID-19 in children:

• COVID-19 Community Child Health Services Guidance for service provision (PDF 211 kB)
  This document has been developed to support service adaptation by community child and youth health services in Queensland Hospital and Health Services (HHSs) during the COVID-19 Pandemic.
• Paediatric emergency care during the COVID-19 pandemic
  This Children’s Health Queensland site contains information specific to the emergency care of children during the COVID-19 outbreak including chest imaging guidelines, consensus statements on intubation and respiratory therapies and a paediatric airway checklist.
• Protecting yourself and the community: mask-wearing video for adolescents
  This video helps Queensland adolescents to understand why wearing a face mask is important. It provides tips for what kind of mask to wear and how to wear it properly. The video is designed for both health professionals and educators who work with high schoolers aged 12 years and above. For more information on COVID-19 and children, visit COVID-19 and your child’s health website.

COVID-19 services guidance and guidelines

• COVID-19 Cancer Guidelines  (PDF 432 kB)
  This document provides a guideline for treatment prioritisation when managing cancer patients during the COVID-19 pandemic.
• COVID-19 Guidelines for Diabetes Services (PDF 442 kB)
  This document provides general guidance for consideration by diabetes endocrine services to complement HHS planning and response activities.
• Considerations for the delivery of palliative care during the COVID-19 pandemic (PDF 913 kB)
  This guideline is for Queensland Health staff working across various settings to support and optimise the inclusion of planning for the delivery of palliative care services.
• COVID-19 Persistent Pain Management Response Guidelines (PDF 313 kB)
  This guideline is to provide Queensland Health Persistent Pain clinics with advice about key issues to consider when planning and preparing for the provision of services during the COVID-19 pandemic.
• COVID-19 Preparedness for Renal Units   (PDF 333 kB)
  This guideline is to provide Queensland Health Renal Units with advice about key issues to consider when planning and preparing for the provision of services as we move into the next phase of living with COVID-19.
• COVID-19 Response Plan Guideline – Sexual Health Services (PDF 234 kB)
  The purpose of this document is to provide Queensland Health Sexual Health Services with a guideline to refer to regarding their response to COVID-19, and a generic COVID-19 response plan that may be tailored for their individual service’s use.
• COVID-19 Guidance for Stroke Services Position Statement (PDF 347 kB)
  This document is to highlight potential impacts the COVID-19 pandemic may have on access to timely assessment and treatment for both ischaemic and haemorrhagic stroke.
• COVID-19 Trauma Services Escalation Plan (PDF 323 kB)
  This document aims to provide guidance to Queensland Hospital and Health Services regarding the management of major trauma patients during the COVID-19 pandemic by outlining referral pathways, escalation trigger points and a communication strategy to assist with continuation of trauma services in the case of a community COVID-19 outbreak.

Intensive Care

• Clinical Guidelines - ICU inpatient clearance of COVID-19 infection
  The Statewide Intensive Care Clinical Network in coordination with the Statewide Infectious Clinical Network  have developed clinical guidelines to assist determining when an Intensive Care Unit (ICU) inpatient may be considered cleared of COVID-19 and can be moved from a designated COVID area to a non-COVID area to continue treatment.   The clinical guidelines assist in a consistent approach across Queensland ICUs in determining COVID clearance, and the collection of uniform reporting for statewide and national reporting.
• Queensland Adaptive Model for the Intensive Care Workforce during COVID-19 (PDF 865 kB)
  This document aims to support HHSs to adapt workforce models in ICUs in response to the COVID-19 pandemic.
• Queensland Intensive Care Support and Telehealth Program support guide (PDF 256 kB)
  The Queensland Intensive Care Support and Telehealth Program (QICSTeP) was developed as a contingency to mitigate the potential impact of COVID-19 on statewide critical care provision. QICSTeP supports Queensland clinicians in accessing advice from intensive care specialists when managing either critically unwell adult patients or patients deteriorating and at risk of becoming critically unwell. QICSTeP is a phased service consisting of three phases, enabling the service to be escalated and de-escalated in response to the evolving Covid-19 pandemic.

Respiratory

• Interim COVID-19 Guidance for Respiratory Services (PDF 215 kB)
  This document is to inform health care workers of the need to plan for the impact of COVID-19 epidemic on delivery of normal respiratory health services.
• Aerosol generated respiratory therapies - High flow nasal prong oxygen (HFNP02) (PDF 194 kB)
  This document provides guidance and support to clinicians in the use of high flow nasal prong oxygen (HFNP02).
• Aerosol generated respiratory therapies - Nebulisers (PDF 243 kB)
  This document provides guidance and support clinicians considering using nebulisers during the COVID-19 pandemic.
• Aerosol generated respiratory therapies - Non-invasive ventilation (NIV) (PDF 175 kB)
  This document provides guidance and support to clinicians that are required to perform non-invasive ventilation (NIV).
• Aerosol generated respiratory therapies - Respiratory Physiotherapy (PDF 159 kB)
  This document provides guidance and support to respiratory physiotherapists to deliver care during the COVID-19 pandemic.

End of life care

• Care at End of Life – Clinical Excellence Queensland
• Office of Advance Care Planning – Metro South Health
• Palliative care for aged care residents with COVID-19
• COVID-19 caring@home resources
• ANZSPM Guidance - palliative care in the COVID-19 context