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Long covid: research must guide future management
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Journal Article
Long covid: research must guide future management
2021
Overview
Bodies including the National Institute for Health and Clinical Excellence (NICE), the Scottish Intercollegiate guidelines network (SIGN), the Royal College of General Practitioners (RCGP) and the Centres for Disease Control and Prevention (CDC) in the US have all attempted to operationally define persistent symptoms and disability after acute covid-19 illness.3 I think the term used by NICE—post-covid-19 syndrome—is a reasonable starting point. Because there is no accompanying positive explanation for the symptoms, this is perceived as implying, “it’s not real” or somehow worse, that “it’s all in your mind.” Emerging evidence suggests that long-covid is as likely to follow mild and even unconfirmed infection as severe illness requiring hospitalisation and respiratory support, although population-based studies on non-hospitalised cases are required to complete the picture.4 New preliminary data suggest that people admitted to hospital with covid-19 who reported long covid symptoms had made only limited improvement after a full year.5 The demographic risk factors for covid-19 illness: age, male sex, ethnic minority status, underlying medication conditions, etc., do not seem to apply to post-covid syndrome.6 This all points to the need to improve our understanding of post-covid syndrome.
