Long COVID: a dynamic review of the evidence by the NIHR – Summary of key points

In its second report on ‘Living with COVID19’, the National Institute for Health Research has focused on the published evidence; read our summary of the key insights into the challenges faced by those affected.

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The NIHR has released its second of two dynamic reviews of the evidence around people’s experience of the enduring symptoms following a COVID-19 infection. Below is a summary of the key points from Living with COVID19.

You can also read the the full report here.

Living with COVID19 Key points

Long COVID: abstract image of red virus particles over a blue disc

The NIHR second report covers research across three themes:

  • How common is long COVID?
  • What causes long COVID?
  • How might long COVID be treated?

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How common is long COVID?

  • One of the key features of long COVID is the wide range of symptoms, however it is noted that there is a lack of knowledge of the different clusters and patterns of symptoms
  • For individuals not admitted to hospital, at least 20–30% experience at least one enduring symptom around 1 month later
  • For those who were admitted to hospital, 50–89% were found to have at least one enduring symptom after 2 months
  • Long COVID appears to occur more frequently in women and young people (including children) than might have been expected from acute mortality data
  • Data about ethnicity and incidence of long COVID are currently limited
  • The physical, psychological and social impact for some individuals with long COVID can be severe

What causes long COVID?

  • The uncertainty about the aetiology of long COVID means it is difficult to predict who will experience severe consequences
  • There is no clear evidence or clinical consensus about the cause of long COVID—understanding more about the cause will help with the design of treatment and prevention of the condition

How might long COVID be treated?

  • A full assessment should be carried out for all people reporting enduring symptoms associated with a confirmed or suspected COVID-19 infection
  • To date, management of long COVID has focused primarily on ruling out other diagnoses, treating individual symptoms, and providing functional rehabilitation
  • Long COVID can be a multisystem disease, which will require joined-up management across specialities between primary and secondary care
  • The report concludes that the journey of long COVID is not well understood, suggests a range of research recommendations, and highlights the importance of continuing to learn directly from those living with this condition—read the full report.


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