Long COVID Defined Ahead of UK Guidelines

Nicky Broyd

October 30, 2020

UK health bodies have defined the syndrome known as long COVID ahead of developing a new treatment guideline. 

The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of GPs (RCGP) defined post-COVID syndrome as:

"Signs and symptoms that develop during or following an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis. It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body.

"Post-COVID-19 syndrome may be considered before 12 weeks while the possibility of an alternative underlying disease is also being assessed."

The scoping document says signs and symptoms can affect different body systems, and can overlap and change over time, including cardiovascular, respiratory, gastrointestinal, neurological, musculoskeletal, metabolic, renal, dermatological, otolaryngological, haematological, and autonomic systems. In addition, patients may have psychiatric problems, generalised pain, fatigue, and persistent fever.

The future guideline, due to be published by the end of the year, will cover specialist referrals, pharmacological and non-pharmacological interventions, and best practices for post-COVID syndrome recovery and rehabilitation services.

It will be a 'living' guideline and subject to updates as new evidence emerges.

Catch-all Term

It's estimated that as many as 60,000 people in the UK may have long COVID and earlier this month the National Institute for Health Research (NIHR) released a review suggesting it could actually be four syndromes.

In a news release, Paul Chrisp, director of the Centre for Guidelines at NICE, said: "This is a new condition and there is still a lot we don’t know about it. Our aim is that the post-COVID syndrome guideline will begin by setting best practice standards of care based on the current evidence but, as our understanding of the condition grows, be adaptable and responsive to new evidence as it emerges."

Safia Qureshi, director of evidence for Healthcare Improvement Scotland, said: "The scope report is a first and vital stage in the production of a guideline which aims to identify symptoms and outline treatment options. We’re delighted to work with NICE and the RCGP on this important piece of work."

RCGP Chair Professor Martin Marshall, said: "Before we can effectively diagnose, treat and manage a condition, we need to know what we're dealing with, so it’s encouraging to be making such rapid progress in this regard as we work with NICE and SIGN to develop this important guidance."

He added: "Now that we are clear about its scope, we can move forward in developing guidance, based on the latest evidence, to support GPs to deliver the most appropriate care and support to patients suffering with the long-term effects of COVID-19 in the community. This guidance will need to evolve as our understanding of the condition grows through clinical experience and robust research."

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