England have received mixed news on the eve of their pivotal Guinness Six Nations clash with Ireland after Maro Itoje emerged as a doubt through illness at the same time as Kyle Sinckler was given the all-clear.

Itoje became unwell overnight and was unable to take part in Friday’s captain’s run, resulting in replacement Joe Launchbury joining Charlie Ewels in the second row for the week’s final practice session.

England are optimistic that Itoje will recover in time for the Twickenham showdown but cannot afford to lose a forward of his calibre if Andy Farrell’s men are to be toppled in the penultimate round of the tournament.

Kyle Sinckler has recovered from a back injury that prevented him from training this week
Kyle Sinckler has recovered from a back injury that prevented him from training this week (David Davies/PA)

Forwards coach Matt Proudfoot has revealed that if the Saracens lock is unable to recover in time, then Launchbury will start alongside Ewels with Nick Isiekwe or Ollie Chessum stepping up to the bench.

Sinckler’s availability hinged on coming through a fitness check on Friday after being unable to train all week because of a back issue, but the tighthead prop has been cleared for the make-or-break title showdown.

Adding to the late disruption, Proudfoot’s fellow forward coach Richard Cockerill became the latest member of England’s camp to test positive for Covid and he will not be present at Twickenham due to self-isolation.

“Kyle fully trained. He had a great training session and looked really good,” Proudfoot said.

“Maro was a little sick overnight so we’re just giving him an opportunity to recover, but we’re really optimistic he’ll be all right.”

Itoje sets the physical tone for England, particularly in defence where he is a master of disruption, and his loss would leave a hole at the heart of their pack, but Proudfoot insists Launchbury would be a capable deputy.

“Maro’s a world class player and his X-factor is the amount of pressure he can apply. But we have a guy who has got 69 caps in Joe Launchbury and his speciality is the physicality he brings,” he said.

The rivals clash for the 139th time knowing that the losing side will be removed from title contention, while the winner will go on to challenge favourites France on the final weekend.

Even with the match being staged at Twickenham, bookmakers are backing Ireland to win and Proudfoot is braced for England’s biggest test since South Africa were toppled in the autumn.

“For us it’s a great opportunity to go after them. The team has trained really, really well and every week it’s got more and more competitive,” he said.

“The preparation has been great and when they walked off the field today (Friday), you could see the confidence in the eyes of the players.

“We know we’ve got to go after them. Ireland have been together for a big part of the year because of their large Leinster contingent, so we know they have that as an advantage, but we’re eager for the opportunity.

“It tends to be the deeper you go into the Six Nations, it gets more and more intense. This is probably going to be the most intense game we’ve played since the Springboks.”