2.2 Symptoms

These recommendations are for healthcare professionals assessing people in any healthcare setting, 4 weeks or more after the start of suspected or confirmed acute COVID-19.

2.2 Be aware that people can have wide-ranging and fluctuating symptoms after acute COVID‑19, which can change in nature over time (see info box below).

2.3 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. 

Info Box

Symptoms after acute COVID-19 are highly variable and wide ranging. The most commonly reported symptoms include (but are not limited to) the following:
Respiratory symptoms
– Breathlessness
– Cough
Cardiovascular symptoms
– Chest tightness
– Chest pain
– Palpitations
Generalised symptoms
– Fatigue
– Fever
– Pain
Neurological symptoms
– 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
Gastrointestinal symptoms
– Abdominal pain
– Nausea and vomiting
– Diarrhoea
– Weight loss and reduced appetite
Musculoskeletal symptoms
– Joint pain
– Muscle pain
Ear, nose and throat symptoms
– Tinnitus
– Earache
– Sore throat
– Dizziness
– Loss of taste and/or smell
– Nasal congestion
Dermatological symptoms
– Skin rashes
– Hair loss
Psychological/psychiatric symptoms 
– Symptoms of depression
– Symptoms of anxiety
– Symptoms of post-traumatic stress disorder

 The following symptoms and signs are less commonly reported in children and young people than in adults
– shortness of breath
– persistent cough
– pain on breathing
– palpitations
– variations in heart rate
– chest pain.

2.4 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.

2.5 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.

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

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