Long-COVID: what it means and how to manage the longer-term effects
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Long-COVID: what it means and how to manage the longer-term effects

Erin Dean Health journalist

Essential information

Many people who have had COVID-19 have reported ongoing symptoms weeks and months after they first fell ill. There is growing evidence that people can experience long-term health effects and about 10% of people with initially mild illness report symptoms lasting more than four weeks.

Emergency Nurse. 29, 3, 11-11. doi: 10.7748/en.29.3.11.s9

Published: 04 May 2021

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Picture credit: iStock

What’s new?

A guideline on the management of the long-term effects of COVID-19, also known as long-COVID, has been published by the National Institute for Health and Care Excellence (NICE), the Royal College of General Practitioners and the Scottish Intercollegiate Guidelines Network.

It includes the following three definitions:

  • 1. Acute COVID-19: the first four weeks of symptoms.

  • 2. Ongoing symptomatic COVID-19: symptoms from four to 12 weeks.

  • 3. Post-COVID-19 syndrome: symptoms for more than 12 weeks.

Long-COVID covers ongoing symptomatic COVID-19 and post-COVID-19 syndrome.

Meanwhile, an England-wide network of specialist clinics helping people recover from the long-term effects of COVID-19 has grown to more than 60 sites. The Queen’s Nursing Institute has also published a resource for community nurses called Living with COVID-19 (long-COVID) and Beyond.

Signs and symptoms

Symptoms after acute COVID-19 are highly variable and wide ranging, NICE says.

The most commonly reported include: breathlessness, cough, chest tightness or pain, palpitations, fatigue, fever, loss of concentration or memory issues, headache, sleep disturbance, dizziness, delirium in older people, pins and needles, skin rash and depression and anxiety.

Causes and risk factors

Much is unknown about what puts someone at risk of long-COVID, but it is not thought to be linked to the severity of acute COVID-19.

How you can help your patient

  • » Use a holistic, person-centred approach.

  • » Be aware that people can have wide-ranging and fluctuating symptoms.

  • » Discuss the person’s experience of their symptoms and ask about their worries.

  • » Explain that recovery time varies but for many people symptoms will resolve by 12 weeks. » Consider additional support for older people.

  • » Give advice on self-management to people with ongoing symptoms.

  • » Healthcare professionals in secondary care should offer a follow-up consultation at six weeks after discharge to people who have been in hospital with acute COVID-19.

Expert Comment

Sharon Aldridge-Bent Director of nursing programmes, The Queen’s Nursing Institute

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‘The impact of long-COVID on the UK population is of huge significance as we continue to see this new wave of physical and emotional health problems.

‘People are presenting to primary and community care services for information, advice and support. The National Institute for Health and Care Excellence guidance has been particularly useful in confirming clinical definitions of the acute stage, ongoing symptoms and the post-COVID stage of the virus. It highlights the importance of assessment, with an emphasis on the fluctuating nature of long-COVID. This information is fundamental to all nurses, including district and general practice nurses who come into daily contact with patients.

‘The most important aspect of the guidance, which is also emphasised in the Queen’s Nursing Institute resource, is the need to listen to the “lived experience” of the person and holistic assessment to ensure the investigation and referral of patients to appropriate treatment centres.’

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