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The likelihood of developing long term effects of covid-19 is not thought to be related to the severity of the acute infection
The most common symptoms of long term covid-19 are fatigue and breathlessness. Symptoms may be singular, multiple, constant, transient, or fluctuating, and can change in nature over time
Offer a chest radiograph by 12 weeks after acute covid-19 if the person has not had one already and has continuing respiratory symptoms
For a proportion of people covid-19 leads to long term effects that can have a significant impact on quality of life. According to the Office for National Statistics, around one in five people testing positive for covid-19 exhibit symptoms for a period of five weeks or more.1 This presents challenges for determining best-practice standards of care. As yet, no commonly agreed clinical definition of long term covid-19 exists, nor a clear definition of treatment pathway. To assist clinicians, the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN), and the Royal College of General Practitioners (RCGP) have developed the “COVID-19 rapid guideline: managing the long term effects of COVID-19.”2 It covers care for people with signs and symptoms that continue for more than four weeks, and which developed during or after an infection consistent with covid-19, and which are not explained by alternative diagnoses.
The guideline provides clinical definitions of the effects of covid-19 at different times and provides advice on diagnosis and management based on the best available evidence and the knowledge and experience of the expert panel. It will be subject to a “living” approach, which means that targeted areas of the guideline will be reviewed weekly and updated in response to emerging evidence and evolving expert experience. This article summarises the guideline recommendations as published on 18 December 2020, with particular emphasis on primary care. Updates are available on the NICE website.2
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