How should I manage a patient with long COVID symptoms in a primary care environment?

Manage a patient with long COVID symptoms in primary care by using shared decision-making to determine follow-up frequency, monitoring, and involvement of healthcare professionals, considering whether appointments should be in person or remote ¹.

Encourage reporting of new or worsening symptoms and discuss changes in activities or routines ¹.

Consider supported self-monitoring at home, including heart rate, blood pressure, pulse oximetry, or symptom diaries, with clear instructions on use and thresholds for seeking further help ¹.

Share clinical records, care, and rehabilitation plans promptly between services, and provide the patient with copies of their records and plans ¹.

Address specific symptoms appropriately, such as anxiety, breathlessness, chest pain, cough, depression, fatigue, headache, joint and muscle pain, palpitations, sleep disturbance, tinnitus, and other relevant issues, following appropriate guidelines ¹.

Offer lifestyle advice, including management of pre-existing conditions, and discuss COVID vaccination, noting that vaccines may modestly improve symptoms but benefits vary ¹.

Discuss options for self-management, including signposting to resources like the Your COVID Recovery website, social prescribing, peer support, and online platforms ¹.

Arrange emergency admission for life-threatening signs, or referral based on clinical judgment, and involve multidisciplinary teams or specialist care as needed, using shared decision-making to tailor support and rehabilitation ¹.