COVID-19 rapid guideline: managing the long-term effects of COVID-19

For people with ongoing symptomatic COVID-19 or suspected post-COVID-19 syndrome who have been identified as needing an assessment, use a holistic, person-centred approach. Include a comprehensive clinical history and appropriate examination that involves assessing physical, cognitive, psychological and psychiatric symptoms, as well as functional abilities.

Include in the comprehensive clinical history:

• history of acute COVID-19 (suspected or confirmed)

• the nature and severity of previous and current symptoms

• timing and duration of symptoms since the start of acute COVID-19

• history of other health conditions

• exacerbation of pre-existing conditions. [2020]

Be aware that people can have wide-ranging and fluctuating symptoms after acute COVID‑19, which can change in nature over time (see section 9 on common symptoms). [2020]

Discuss the person's experience of their symptoms and how their life and activities have been affected, including work, education, mobility and independence. Ask about any feelings of worry or distress. Listen to their concerns with empathy and acknowledge the impact on their day-to-day life. [2020, amended 2021]

For people who may benefit from support during their assessment, for example, to help describe their symptoms, include a family member or carer in discussions if the person agrees.

For more advice on supporting adults to make their own decisions if they lack mental capacity, see NICE's guideline on decision making and mental capacity and the Adults with Incapacity (Scotland) Act 2000, with further guidance available from the Mental Welfare Commission for Scotland. [2020]

Do not predict whether a person is likely to develop post‑COVID‑19 syndrome based on whether they had certain symptoms (or clusters of symptoms) or were in hospital during acute COVID‑19. [2020]

If the person reports new cognitive symptoms, use a validated screening tool to measure any impairment and impact. [2020]