New NICE guidelines on long Covid

A guideline on managing the long-term effects of COVID-19, or ‘long COVID’, has been published by leading health bodies. The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) jointly developed the guideline, which was published on 18 December. 

The collaborative effort provides “recommendations based on the current evidence and expert consensus” but will also continue to adapt and react to the latest updates. The literature is intended for health and care practitioners, to help with the care of patients whose symptoms, consistent with COVID-19, last for over four weeks with no alternative diagnosis. 

In the document, which can be found on the NICE website, clinical definitions are provided for stages ranging from initial illness to Post-COVID-19 syndrome. Recommendations cover areas such as:

  • Identifying people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome
  • Assessing people with new or ongoing symptoms
  • Planning care
  • Management
  • Follow-up and monitoring 
  • Sharing information and continuity of care
  • Service organisation.

Health inequalities are also emphasised, as well as the need for raising awareness to improve access to care and suggestions for research to further develop the guideline.

A complementary booklet for patients, intended to help with understanding of the illness and the care people can expect to receive, has also been produced. 

“This guideline highlights the importance of providing people with good information after they’ve had acute COVID-19 so they know what to expect and when they should ask for more medical advice,” said Paul Chrisp, director of the Centre for Guidelines at NICE.

“This could help to relieve anxiety when people do not recover in the way they expect. Because this is a new condition and there is still much that we don’t about it, the guidance will be adaptable and responsive as understanding of the condition grows and new evidence about how to manage it emerges.”

On average, the majority of people experience COVID-19 symptoms that resolve within 12 weeks. But a significant minority can suffer from persistent, new or worsening symptoms that impact their quality of life. 

Some of the many and varied long-term symptoms noted include shortness of breath, fatigue and problems that effect organs, muscles, joints and the nervous system. 

The guideline announcement comes during a week when the impact of ‘long COVID’ has been given ample coverage by media, thanks to the announcement of the locations of new, specialist ‘long COVID’ clinics across the UK. There are expected to be 81 in total, as the NHS mounts a nation-wide response to the long-term impacts of COVID-19.