Healthcare staff need more information to treat ‘long Covid’

Research from the National Institute for Health Research (NIHR) has argued that people suffering from ‘long Covid’ – or often debilitating systems that can recur for weeks or months after someone has nominally recovered from the virus – need more support, while healthcare staff need better information to diagnose and treat the condition.

NIHR’s Living with Covid-19 report also concluded that a range of “fluctuating and multisystem” symptoms can be associated with long Covid. A common theme is that symptoms arise in one physiological system, only to arise in another system once abated, it highlighted. This can have significant psychological and social effects if not well managed, the report said.

Symptoms affecting the breathing, brain, heart, kidneys, liver, gut and skin may be present because of four different reasons, the report suggested. These were:

  • permanent organ damage to the lungs and heart
  • post-intensive-care syndrome
  • post-viral fatigue syndrome
  • continuing Covid-19 symptoms.

The report said: “The multisystem nature of ongoing Covid-19 means that it needs to be considered holistically (both in service provision and in research).

“The varying degrees of dependency mean support in the community should be considered alongside hospital one-stop clinics. Social support needs to be understood together with the financial pressures on previously economically active people.

“A major obstacle is the lack of consensus on diagnostic criteria for ongoing Covid-19. A working diagnosis that is recognised by healthcare services, employers and government agencies would facilitate access to much needed support and provide the basis for planning appropriate services. Whilst it is too early to give a precise definition, guidance on reaching a working diagnosis and a code for clinical datasets is needed.”

The institute concluded that many questions about the long-term impact of Covid-19 remain unanswered, including:

  • What are the risk factors and therefore who is at greatest risk of experiencing long-term problems?
  • What is the impact of living with Covid-19 on families and carers? How can social support, including that provided by voluntary agencies, help?
  • What are the financial pressures on previously economically active people?
  • Acute Covid-19 infection has already had a disproportionate effect on certain parts of the population. Is this mirrored in ongoing Covid-19?

Its research was based on interviews with 14 members of a long Covid support group on Facebook, as well as recent published studies.

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