1.5 New and ongoing symptoms after acute Covid-19

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1.5 For people with new or ongoing symptoms after acute COVID‑19, suspect:

  • ongoing symptomatic COVID-19 if people present with symptoms 4 to 12 weeks after the start of acute COVID‑19 or
  • post-COVID-19 syndrome if the person’s symptoms have not resolved 12 weeks after the start of acute COVID‑19.

1.6 For people who are experiencing new or ongoing symptoms 4 weeks or more after acute COVID‑19, offer an initial consultation and use shared decision making to discuss and agree with the person whether it should be remote or in person.

1.7 Consider using a screening questionnaire as part of the initial consultation to help capture all of the person’s symptoms. These should only be used in conjunction with clinical assessment.

Info Box

Some people (including children and older people) may not have the most commonly reported new or ongoing symptoms after acute COVID‑19.
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.

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Info Box

In addition to clinical symptoms, people who report increased absence or reduced performance in their education, work or training after acute COVID-19 may have ongoing symptomatic COVID-19 or post-COVID-19 syndrome and may need extra support and recovery time.
When investigating possible causes of a gradual decline, deconditioning, worsening frailty or dementia, or loss of interest in eating and drinking in older people, bear in mind that these can be signs of ongoing symptomatic COVID‑19 or suspected post‑COVID‑19 syndrome.

1.8 Need for further assessment and referral

  • Based on the initial consultation, use shared decision making to discuss and agree with the person whether they need a further assessment and whether this should be remote or in person.
  • Take into account whether they may have symptoms that need investigating in person or require urgent referral to an appropriate service.

1.9 Support access to assessment and care for people with new or ongoing symptoms after acute COVID‑19, particularly for those in underserved or vulnerable groups who may have difficulty accessing services, for example by:

  • providing extra time or additional support (such as an interpreter or advocate) during consultations.
  • raising awareness about possible new or ongoing symptomatic COVID‑19 or post-COVID-19 syndrome – this may include working with local community leaders or organisations – particularly in vulnerable groups and black, Asian and minority ethnic groups.
  • See the equality impact assessment for more information about the equality issues considered.

Proactive follow-up after acute Covid-19

1.10 Consider follow up by primary care or community services for people in vulnerable or high‑risk groups who have self‑managed in the community after suspected or confirmed acute COVID‑19. 

1.11 A healthcare professional in secondary care should offer a follow‑up consultation at 6 weeks after discharge to people who have been in hospital with acute COVID‑19 to check for new or ongoing symptoms or complications.

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