The purpose of this guideline is to maximise the safety of children and adults with rheumatological autoimmune, inflammatory and metabolic bone disorders during the COVID-19 pandemic, while protecting staff from infection. It also enables services to make the best use of NHS resources. we integrated content from the NHS England specialty guide on rheumatology during the coronavirus pandemic into this guideline. This includes information on making treatment decisions based on the person’s condition and their medicines, advice on shielding and self-isolation, and recommendations on organising services based on COVID-19 prevalence. we highlighted the possible risk of adrenal crisis for patients on long-term corticosteroids. This guideline focuses on what you need to stop or start doing during the pandemic. Follow the usual professional guidelines, standards and laws (including those on equalities, safeguarding, communication and mental capacity), as described in making decisions using NICE guidelines. This guideline is for: health and care practitioners; health and care staff involved in planning and delivering services; commissioners. The recommendations bring together: existing national and international guidance and policies; advice from specialists working in the NHS from across the UK. These include people with expertise and experience of treating patients for the specific health conditions covered by the guidance during the current COVID-19 pandemic. NICE has also produced COVID-19 rapid guidelines on children and young people who are immunocompromised and arranging planned care in hospitals and diagnostic services, which should be read alongside this guideline. We developed this guideline using the interim process and methods for developing rapid guidelines on COVID-19 in response to the rapidly evolving situation. We will review and update the recommendations as the knowledge base develops using the interim process and methods for guidelines developed in response to health and social care emergencies.