1 Identifying people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome

1 Identifying people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome

These recommendations are for healthcare professionals caring for people who have had suspected or confirmed acute COVID-19 and present to any healthcare setting, irrespective of whether they were hospitalised or had a positive or negative SARS‑CoV‑2 test (PCR, antigen or antibody).

1.1 Give people who have had suspected or confirmed acute COVID‑19 (and their families or carers, as appropriate) advice and written information on:

  • the most common new or ongoing symptoms after acute COVID‑19 (see the section on common symptoms of ongoing symptomatic COVID-19 and post-COVID-19 syndrome)

  • what they might expect during their recovery, including that:

    • recovery time is different for everyone but for many people symptoms will resolve by 12 weeks

    • the likelihood of developing ongoing symptomatic COVID-19 or post-COVID-19 syndrome is not thought to be linked to the severity of their acute COVID‑19 (including whether they were in hospital)

    • if new or ongoing symptoms occur they can change unpredictably, affecting them in different ways at different times

  • how to self-manage ongoing symptomatic COVID‑19 or post‑COVID‑19 syndrome (see the recommendations on self-management and supported self-management)

  • symptoms to look out for that mean they should contact their healthcare professional

  • who to contact if they are worried about new, ongoing or worsening symptoms, especially if they have them more than 4 weeks after the start of acute COVID‑19.

1.2 Provide all information in accessible formats so that people can understand and take part in decisions about their care. Follow relevant national guidance on communication, providing information (including different formats and languages) and shared decision making, for example, NICE's guideline on patient experience in adult NHS services.

1.3 Suspect previous COVID‑19 illness as a possible underlying cause of new or ongoing symptoms in people after acute COVID‑19 as follows:

  • ongoing symptomatic COVID-19 if people present with symptoms 4 to 12 weeks after the start of acute COVID‑19 or

  • post-COVID-19 syndrome if the person's symptoms have not resolved 12 weeks after the start of acute COVID‑19.

1.4 For people who are concerned about new or ongoing symptoms 4 weeks or more after acute COVID‑19, offer an initial consultation and use shared decision making to discuss and agree with the person whether it should be by video, phone or in person.

1.5 Consider using a screening questionnaire as part of the initial consultation to help capture all of the person's symptoms. These should only be used in conjunction with clinical assessment.

1.6 Be aware that some people (including children and older people) may not have the most commonly reported new or ongoing symptoms after acute COVID‑19.

1.7 Based on the initial consultation, use shared decision making to discuss and agree with the person whether they need a further assessment and whether this should be by phone, video or in person. Take into account whether they may have symptoms that need investigating in person or require urgent referral to an appropriate service.

1.8 Support access to assessment and care for people with new or ongoing symptoms after acute COVID‑19, particularly for those in underserved or vulnerable groups who may have difficulty accessing services, for example by:

  • providing extra time or additional support (such as an interpreter or advocate) during consultations

  • raising awareness about possible new or ongoing symptoms of COVID‑19 – this may include working with local community leaders or organisations – particularly in vulnerable groups and black, Asian and minority ethnic groups.

    See the equality impact assessment for more information about the equality issues considered.

1.9 Consider follow-up by primary care or community services for people in vulnerable or high‑risk groups who have self‑managed in the community after suspected or confirmed acute COVID‑19.

1.10 A healthcare professional in secondary care should offer a video or phone follow‑up consultation at 6 weeks after discharge to people who have been in hospital with acute COVID‑19 to check for new or ongoing symptoms or complications.