NICE, the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) have today published a guideline on the management of the long-term effects of COVID-19, also known as Long COVID.
The guideline covers the care of people who have signs and symptoms that develop during or after an infection consistent with COVID-19, that continue for more than four weeks and are not explained by an alternative diagnosis. It provides recommendations based on the current evidence and expert consensus, and will be adapted as new evidence emerges.
Most people’s symptoms of COVID-19 resolve within 12 weeks. However, for a sizeable minority of people symptoms can persist or new ones develop, and can sometimes worsen, and have a continuing detrimental impact on their quality of life. Longer-term impacts can include shortness of breath, fatigue, and problems involving the heart, lungs, kidneys, nervous system and muscles and joints.
The guideline says that people may have ongoing symptomatic COVID-19 if they present with symptoms 4 to 12 weeks after the start of acute symptoms and may have post-COVID syndrome if their symptoms have not resolved after 12 weeks.
The guideline also emphasises the need to address health inequalities in care for people experiencing ongoing symptoms. It recommends providing extra support and raising awareness to help improve access to care, as well as more proactive follow-up of people from vulnerable/high-risk groups who could be at increased risk of complications.
The guideline makes recommendations in a number of other key areas, including:
- Assessing people with new or ongoing symptoms after acute COVID-19
- Investigations and referral
- Planning care
- Management, including self-management, supported self-management, and rehabilitation
- Follow-up and monitoring
- Service organisation.
The guideline also includes a number of key recommendations for research which will help inform and enhance future versions as evidence and practice develops.
This guideline highlights the importance of providing people with good information after they’ve had acute COVID-19 so they know what to expect and when they should ask for more medical advice. This could help to relieve anxiety when people do not recover in the way they expect, particularly because symptoms can fluctuate and there are so many different symptoms reported.
Because this is a new condition and there is still much that we don’t know about it, the guideline will be adaptable and responsive as understanding of the condition grows and new evidence about how to manage it emerges.”
— Paul Chrisp, director of the Centre for Guidelines at NICE
Professor Martin Marshall, Chair of the Royal College of GPs, said:
“The College has been delighted to work with NICE and SIGN to develop these clinical guidelines. We hope they will be useful for GPs and other healthcare professionals and will have a positive impact on the care delivered to patients with prolonged symptoms of COVID-19. We’ve also produced a booklet for patients to help them understand their illness.
“It’s been a rapid but rigorous process, during which we have listened to both clinicians and patients who have had ongoing symptoms as a result of COVID-19 to ensure the guidance is as holistic and comprehensive as possible given what we know..."