Post-COVID-19 syndrome and 'long-COVID' - guidance for clinicians

Research has shown that long-COVID or Post-COVID-19 Syndrome can include psychological, psychiatric and neuropsychiatric symptoms.

This page brings together the current professional guidance on managing this new and emerging condition and the symptoms associated with it. We will continue to update this page as new guidance and evidence emerge. 

 The National Institute for Health and Care Excellence (NICE) outlines the following definitions around what has been commonly described as 'long-Covid':

  • Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from 4 to 12 weeks.
  • Post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.

Below is the recently developed COVID-19 rapid guideline which can support health and care practitioners in managing these symptoms and providing adequate care for patients experiencing difficulties with mental health symptoms associated with the long-term effects of COVID-19. This guideline has been developed jointly by NICE, the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP).

The guideline includes recommendations on identifying people with ongoing symptomatic COVID-19 or post-COVID-19 syndrome, investigations and referral and planning care. It recommends that:

  • People with ongoing symptoms four weeks or more after the start of suspected or confirmed acute COVID-19 should be urgently referred to psychiatric assessment if they have severe psychiatric symptoms or are at risk of self-harm or suicide.
  • Primary care and community settings should follow relevant national or local guidelines on referral for people who have anxiety and mood disorders, or other psychiatric symptoms. Referral to liaison psychiatry should be considered, especially if they have a complex physical and mental health presentation.
  • Physical, psychological and psychiatric aspects of rehabilitation should be considered. The core team could include clinical psychology and psychiatry. 
  • They have applied a ‘living’ approach which means that targeted areas of the guideline will be continuously reviewed and updated in response to emerging evidence. 

NICE have applied a ‘living’ approach to the guidance which means that targeted areas of the guideline will be continuously reviewed and updated in response to emerging evidence. 

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

NHS England and NHS Improvement have also provided national guidance for post-COVID syndrome assessment clinics. This will assist local healthcare systems to establish post-COVID syndrome assessment clinics for patients.

Clinics will offer physical, cognitive and psychological assessments with the aim of providing consistent services to patients. 

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