36 CLINICAL
Treating patients with long Covid
Key learning points
Post-Covid-19 syndrome , often what is meant by ‘ long Covid ’, is symptoms persisting for more than 12 weeks
It can develop even after a mild case of the virus , and symptoms vary widely
Treatment is a combination of medical care and self-management , with referral if symptoms worsen
A t the start of the pandemic Covid-19 was viewed principally as a viral respiratory illness from which most people would recover within a few weeks . As a result , the Government ’ s approach was to adopt a model more suited to a fl u pandemic . While most people with the illness do experience mild to moderate symptoms , around 15 % progress to severe disease requiring hospital treatment , and around 5 % become critically ill . 1
Most people recover within two to six weeks but in some cases , symptoms persist for weeks or months following the initial infection , with some people going on to develop longer-lasting health problems . This is now typically referred to as ‘ long Covid ’, or post-Covid-19 syndrome .
Although there is no widely accepted defi nition , NICE has described post-Covid-19 syndrome – often what is meant by ‘ long Covid ’ – as ‘ signs and symptoms that develop during or after an infection consistent with Covid-19 , continue for more than 12 weeks and are not explained by an alternative diagnosis ’. 2
‘ Ongoing symptomatic Covid-19 ’ is defi ned as symptoms persisting beyond the initial four weeks of acute Covid and up to 12 weeks 2 ; some people also refer to this as ‘ long Covid ’.
The National Institute for Health Research ( NIHR ) has suggested that rather than being a single syndrome , long Covid may be split into four main subtypes : the after-effects of intensive care ; postviral fatigue ; lasting organ damage ; and symptoms that move around the body . 3
Assessing the exact numbers of people with long Covid is diffi cult but a bulletin from the Offi ce for National Statistics in April highlights a study of 20,000 people who had tested positive for Covid-19 , of whom almost 14 % said they continued to experience symptoms after 12 weeks . 4
At this stage , it is diffi cult to predict who may or may not develop long Covid , as even those who have relatively mild symptoms at home can develop the condition , and severity of initial infection is not an automatic marker for prolonged
1 CPD HOURS
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