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

Give advice and information on self-management to people with ongoing symptomatic COVID‑19 or post‑COVID‑19 syndrome, starting from their holistic assessment. This should include:

• ways to self-manage their symptoms, such as setting realistic goals

• who to contact if they are worried about their symptoms or they need support with self‑management

• sources of advice and support, including support groups, social prescribing, online forums and apps

• how to get support from other services, including social care, housing and employment, and advice about financial support

• information about new or continuing symptoms of COVID-19 that the person can share with their family, carers and friends (see section 9 on common symptoms).
  
  Advice for patients on managing common symptoms is available from the Your COVID Recovery website and NHSinform website. [2020]

Explain that it is not known if over-the-counter vitamins and supplements are helpful, harmful or have no effect in the treatment of new or ongoing symptomatic COVID‑19 or post-COVID-19 syndrome.

Support people in discussions with their school, college or employer about returning to education or work, for example, by having a phased return. For advice on returning to work, follow national guidance, for example, NICE's guideline on workplace health: long-term sickness absence and capability to work. [2020]

Use a multidisciplinary approach to guide rehabilitation, including physical, psychological and psychiatric aspects of management. Ensure that any symptoms that could affect the person being able to start rehabilitation safely have been investigated first. See also the recommendation on multidisciplinary rehabilitation teams in section 8 on service organisation. [2020, amended 2021]

Work with the person (and their family or carers, if appropriate) to develop a personalised rehabilitation and management plan that is recorded in a rehabilitation prescription and should include:

• areas of rehabilitation and interventions based on their assessment

• helping the person to decide and work towards goals

• how to manage and monitor their symptoms, taking into account that these may fluctuate, and what to do if symptoms return or change. [2020, amended 2021]

Provide extra time or additional support (such as an interpreter or advocate) to people who would benefit during their consultations. [2020, amended 2021]

Encourage people to keep a record of, or use a tracking app to monitor, their goals, recovery and any changes in their symptoms (see also section 6 on follow-up, monitoring and discharge). [2020]

Consider additional support for people with ongoing symptomatic COVID‑19 or post‑COVID‑19 syndrome who may be vulnerable, for example, older people and people with complex needs. Additional support may include short‑term care packages, advance care planning and support with social isolation, loneliness and bereavement, if relevant. [2020, amended 2021]

Consider referral from 4 weeks for specialist advice for children and young people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome. [2020, amended 2021]