Coronavirus patients to get six-week ‘long Covid’ check-ups

All coronavirus patients who are discharged from hospital should be offered a six-week follow-up appointment to check if they have “long Covid”, according to new guidance released on Friday.

The National Institute for Health and Care Excellence (NICE) recommended that a video or phone check-up should be provided to everyone who leaves hospital after becoming infected with the virus.

NICE said that if symptoms persist after four weeks, patients could have “ongoing symptomatic Covid-19” and if symptoms are not resolved after 12 weeks, they could be diagnosed with what it calls “post-Covid-19 syndrome”.

It has identified 28 of the most common symptoms of long Covid, including breathlessness, chest pain, fatigue, “brain fog”, memory issues, nausea, diarrhoea, joint pain, skin rashes and depression.

Awareness of what has become known as long Covid has grown gradually since the start of the pandemic, with many patients at first struggling to have their condition recognised by medical professionals, and thriving online support groups springing up around the world.

Last month, the NHS began opening specialist clinics for those suffering from long Covid, and now has 69 sites across England to which GPs can refer patients.

The health service said some early research suggested that as many as one in five people who catch the coronavirus will develop long-term symptoms, and earlier this week the Office for National Statistics estimated that 186,000 people have suffered with Covid for more than 12 weeks.

Sir Simon Stevens, the head of NHS England, said the specialist clinics would bring together doctors, nurses, physiotherapists and occupational therapists to help long Covid sufferers get the right support.

“The NHS is taking practical action to help patients suffering ongoing health issues as a result of coronavirus.

“Bringing expert clinicians together in these clinics will deliver an integrated approach to support patients access vital rehabilitation, as well as helping develop a greater understanding of long Covid and its debilitating symptoms.”

“Because this is a new condition, there is still much that we don't know about it,” admitted Paul Chrisp of NICE.

“This [guidance] 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.”

The guidance explains that symptoms of long Covid can be unpredictable and fluctuate swiftly, with even the same patient experiencing different things at different times.

Developing long-term symptoms is not thought to be made more likely by having a more severe case of the coronavirus initially, it adds.

NICE’s guidance has been developed in conjunction with both the Scottish Intercollegiate Guidelines Network and the Royal College of GPs.

Unlike in England, NHS bosses in Scotland and Wales have not opened specialist long Covid clinics but are instead trying to cater for patients within existing services.

Graham Burns, who is the clinical lead at the long Covid centre in Newcastle’s Royal Victoria Infirmary, said he was “delighted” that patients had a network of clinics to call on.

“In the first wave of the pandemic, many people did not recover as quickly as they’d expected.

“We had no idea what long Covid was – the world had never seen Covid-19 before.

“We set up the clinic in Newcastle to support patients, but it has also been invaluable in helping us understand what long Covid is.”

Charlotte Bolton, a professor of respiratory medicine at the University of Nottingham who treats long Covid patients, welcomed the new guidance but warned it also posed more challenges to already overstretched NHS staff.

“Core staff are already delivering standard clinical care during a busy winter period, additional frontline care for the wave two of patients with Covid-19 and also trying to support this follow-up.

“The need is most definitely now. We cannot hold off addressing these persisting symptoms, which for some are impacting on their quality of life greatly.”