NHS will now officially recognise ‘Long Covid’ as long-term coronavirus effect

The NHS will officially recognise ‘Long Covid’ and draw up guidelines for doctors on how to treat the debilitating condition.

As many as 60,000 people in the UK are thought to be suffering from long-lasting effects of coronavirus, which linger after the original illness has cleared up.

Shortness of breath, exhaustion, weakness and even problems with vital organs including the heart, liver, kidneys and brain can result from a bout of the disease.

But doctors have struggled to help people with the illness, which is so varied and apparently random that it has been difficult to study and to diagnose. 

NHS watchdog the National Institute for Health and Care Excellence (NICE) has today announced it will work with doctors to draw up guidance on how to help patients who are suffering from Long Covid.

The move means the illness will be officially written into NHS paperwork and doctors will be given concrete advice about the condition. 

It is not yet clear how medics will be instructed to recognise or treat the condition because people have such a wide range of symptoms. It is also not clear why it develops, but it appears to be most common among women of working age.

Today’s announcement comes after experts warn that Long Covid could become a bigger health issue than deaths caused by the disease, with thousands facing at least months suffering its after-effects with no idea if they’ll ever recover.

People who catch coronavirus report suffering from crippling symptoms for weeks and months after they have cleared the virus from their body and doctors are trying hard to understand the phenomenon and help people affected by it (Pictured: A patient in Forth Valley Royal Hospital in Falkirk, Scotland, in April)

‘There is growing evidence to suggest Covid-19 is a multi-system disease that for many people involves persistent symptoms with longer term impacts on their health,’ said Paul Chrisp, NICE’s director of guidelines.

‘It is important, therefore, that people requiring ongoing support and treatment are identified quickly and are supported by the NHS throughout every stage of their journey. 

‘We also want to ensure that clinicians have clear guidance on how best to support patients struggling with this newly emerging disease.’

The Scottish Intercollegiate Guidelines Network (SIGN) will also work with NICE and the NHS to set up the same system north of the border.

Both bodies have been ordered by NHS England to define Long Covid and write the guidelines for doctors.

WHAT ARE THE LONG-TERM SYMPTOMS OF COVID-19? 

Most coronavirus patients will recover within a fortnight, suffering a fever, cough and losing their sense of smell or taste for several days.

However, evidence is beginning to show that the tell-tale symptoms of the virus can persist for weeks on end in ‘long haulers’ — the term for patients plagued by lasting complications.

Data from the COVID Symptom Study app, by King’s College London and health company Zoe, suggests one in ten people may still have symptoms after three weeks, and some may suffer for months.

Long term symptoms include:

  • Chronic tiredness
  • Breathlessness 
  • Raised heart rate
  • Delusions
  • Strokes
  • Insomnia
  • Loss of taste/smell
  • Kidney disease 
  • Mobility issues
  • Headaches
  • Muscle pains
  • Fevers 

For those with more severe disease, Italian researchers who tracked 143 people who had been hospitalised with the disease found almost 90 per cent still had symptoms including fatigue two months after first falling unwell.

The most common complaints were fatigue, a shortness of breath and joint pain – all of which were reported during their battle with the illness. 

Another study in Italy showed one in ten people who lose their sense of taste and smell with the coronavirus – now recognised as a key sign of the infection – may not get it back within a month.

The study, published in the journal JAMA Otolaryngology – Head and Neck Surgery, involved 187 Italians who had the virus but who were not ill enough to be admitted to hospital.

The UK’s Chief Medical Officer Professor Chris Whitty has said the longer term impacts of Covid-19 on health ‘may be significant’.

Support groups such as Long Covid have popped up online for those who ‘have suspected Covid-19 and your experience doesn’t follow the textbook symptoms or recovery time’.

They will have the help of the Royal College of General Practitioners, which represents more than 50,000 family doctors across the UK.

Together, the experts will come up with an official definition for Long Covid and educate doctors and other medics on how to spot the symptoms of it.

They will also produce advice on how to investigate the condition and suggest ways of treating the symptoms it can cause. 

The guidance is expected by the end of the year.

Chair of the Royal College of GPs, Professor Martin Marshall, said: ‘Treating or managing any new virus or condition is a challenge for healthcare professionals whose priority is always trying to deliver the best possible care for their patients.

‘The College is delighted to be working with both NICE and SIGN to develop this guideline.

‘It aims to support GPs and other healthcare professionals to ensure all patients with long term effects of Covid-19, including those diagnosed in the community irrespective of whether they received a positive test or not, can be cared for in the best possible way, based on the latest evidence.’

Researchers fear that Long Covid could in future become more of a problem for the UK than people dying from coronavirus infection.

Around 60,000 people are thought to have the illness already and the virus is still spreading widely – the condition appears to affect adults of all ages and to not have any obvious at-risk groups. It appears to be more common in working age women.

Professor Tim Spector, an epidemiologist at King’s College London who set up the Covid Symptom Tracker app that is used by millions of Brits, says the reports of people who use the app have been concerning.

Users can report their symptoms and how they’re feeling every day, whether they are sick or not, and enter test results.

Professor Spector said the app, launched in March with the health-science company ZOE, has received data from more than four million people. 

Researchers learned that ‘a great many people didn’t get better after two weeks as expected’, Professor Spector wrote in a foreword to the report ‘Long Covid: Reviewing the Science and Assessing the Risk’, published by the Tony Blair Institute.

He said: ‘We kept following them and found out that a significant number still had problems after months.

‘This is the other side of Covid: the long-haulers that could turn out to be a bigger public health problem than excess deaths from Covid-19, which mainly affect the susceptible elderly.’

The report said Professor Spector’s study indicates around 10 per cent of people had symptoms of Long Covid for a month.

As many as two per cent – one in every 50 people – still had symptoms three months after catching the virus. 

The authors said these appear to be the most reliable statistics on which to base a rough estimate of the scale of Long Covid in the population.

But they said that the proportions are likely a lot lower when everyone who never tested positive or realised they had the illness is taken into account.

The report said long Covid seems rare in those under 18 and over 65, with higher prevalence among those of working age.

The median age of those affected is 45 and it affects women more than men.

People suffering from Long Covid have turned to one another for support in the absence of useful medical advice.

The founder of the Long Covid Support Group, Claire Hastie, said the lasting effects of the illness had left her wheelchair-bound.

Another member of the 15,000-strong group, a doctor, revealed that he was unable to walk up one flight of stairs without getting out of breath.

Ms Hastie, who was diagnosed with Covid-19 in March, claimed that up to 500,000 people in the UK are currently suffering from the long-term effects of Covid-19.

Describing how she used to cycle 13 miles to work but can no longer walk 13 metres and is now largely confined to a wheelchair, Ms Hastie told MPs in August: ‘Many people in our group to this day are being told by their GPs that it’s caused by anxiety and it’s all in their heads.

‘It can cause anxiety but it is not caused by anxiety. The science needs to catch up with us.’