How should I manage a patient presenting with flu-like symptoms who is at high risk for complications?

Management of a patient with flu-like symptoms at high risk for complications:

• Confirm that influenza is circulating in the community, as indicated by national surveillance schemes.
• Assess if the patient belongs to an 'at risk' group, including those aged over 65 years, children under 6 months, pregnant women, and people with chronic conditions such as diabetes, chronic respiratory, cardiovascular, renal, or liver disease, immunosuppression, asplenia, or morbid obesity.
• Start antiviral treatment promptly, ideally within 48 hours of symptom onset (36 hours for zanamivir in children), using oral oseltamivir or inhaled zanamivir, unless contraindicated. This is especially important for high-risk patients to reduce complications.
• If COVID-19 is a possible differential diagnosis, arrange PCR testing but do not delay antiviral initiation if influenza is highly probable.
• Advise the patient to maintain adequate fluid intake, use paracetamol or ibuprofen for symptom relief, rest if fatigued, and stay off work or school until feeling well, usually about one week.
• Educate the patient about signs of complicated influenza, such as worsening shortness of breath, pleuritic chest pain, or coughing up blood, which require urgent medical attention.
• Arrange follow-up if symptoms do not improve or worsen after one week, or sooner if clinical deterioration occurs.
• Consider hospital admission for patients with complicated influenza or those developing pneumonia, especially if they have a high CRB65 score or other risk factors.