Long Covid Symptoms and Diagnosis
Clinical definitions to identify and diagnose Covid-19 effects
Acute Covid-19
Signs and symptoms of COVID‑19 for up to 4 weeks
Ongoing symptomatic Covid-19
Signs and symptoms of COVID‑19 from 4 weeks up to 12 weeks
Post-Covid-19 syndrome = Long Covid
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.
It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body.
Post‑Covid‑19 syndrome may be considered before 12 weeks while the possibility of an alternative underlying disease is also being assessed.
Long Covid DEFINITION
Signs and symptoms that continue or develop after acute COVID‑19
It includes both ongoing symptomatic COVID‑19 (from 4 to 12 weeks) and post‑COVID‑19 syndrome (12 weeks or more)
Common symptoms
Symptoms after acute Covid-19 are highly variable and wide ranging. The most commonly reported symptoms include (but are not limited to) the following:
- Breathlessness
- Cough
- Chest tightness
- Chest pain
- Palpitations
- Fatigue
- Fever
- Pain
- Cognitive impairment (‘brain fog’, loss of concentration or memory issues)
- Headache
- Sleep disturbance
- Peripheral neuropathy symptoms (pins and needles and numbness)
- Dizziness
- Delirium (in older populations)
- Mobility impairment
- Visual disturbance
- Abdominal pain
- Nausea and vomiting
- Diarrhoea
- Weight loss and reduced appetite
- Joint pain
- Muscle pain
- Tinnitus
- Earache
- Sore throat
- Dizziness
- Loss of taste and/or smell
- Nasal congestion
- Skin rashes
- Hair loss
- Symptoms of depression
- Symptoms of anxiety
- Symptoms of post-traumatic stress disorder
Investigations and referral
Tests and Investigations
Tailored to people’s signs and symptoms to rule out acute or life‑threatening complications and find out if symptoms are likely to be caused by ongoing symptomatic Covid‑19, post‑Covid‑19 syndrome i.e. Long Covid or could be a new, unrelated diagnosis.
Acute Complications
Refer people with ongoing symptomatic Covid-19 or suspected post-Covid-19 syndrome urgently to the relevant acute services if they have signs or symptoms that could be caused by an acute or life‑threatening complication.
Severe Psychiatric Symptoms
Refer people with ongoing symptomatic Covid-19 or suspected post‑Covid‑19 syndrome urgently for psychiatric assessment if they have severe psychiatric symptoms or are displaying high risk of self‑harm or suicide.
Other Services
After ruling out acute or life-threatening complications and alternative diagnoses, consider referring people to an appropriate service, such as an integrated multidisciplinary assessment service, any time from 4 weeks after the start of acute Covid‑19.
Source: The NICE Rapid Guideline on Long Covid