Learning Objectives
- Define long COVID using current NICE criteria
- Structure a holistic assessment
- Know appropriate investigation pathways
- Understand MDT referral pathways
NICE Definition
Long COVID includes:
- Ongoing symptomatic COVID-19 — 4-12 weeks after acute infection
- Post-COVID-19 syndrome — signs/symptoms more than 12 weeks after acute infection, not explained by an alternative diagnosis
Assessment
NICE recommends a holistic approach considering:
- Physical, cognitive, psychological symptoms
- Functional capacity and impact on daily life
- Comorbidities that may be exacerbated
Investigation
Initial investigations: FBC, U&E, LFTs, CRP, ferritin, HbA1c, TFTs, 12-lead ECG, pulse oximetry. Consider chest X-ray if respiratory symptoms.
Management Principles
- Acknowledge patient experience and validate symptoms
- Set realistic goals collaboratively
- Pacing and energy management for fatigue
- Refer to specialist long COVID service if available
- Avoid harmful interventions (graded exercise therapy contraindicated if post-exertional malaise)