This month we published an international review of clinical guidelines and or models of care for the diagnosis and management of long COVID. We carried out this review at the request of the Health Service Executive (HSE) to inform the HSE’s interim model of care for long COVID.
The World Health Organization defines long COVID as the continuation or development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation. Long COVID symptoms vary greatly from person to person and can be quite debilitating. The range of symptoms can include breathlessness, cough, brain fog, headache, sleep disturbance, pins and needles, numbness, dizziness, fatigue, abdominal pain, nausea and vomiting, diarrhoea, weight loss, reduced appetite, chest pain, chest tightness and palpitations, among others.
We reviewed 24 guidelines and two models of care from across national, regional and international authorities, and found that the evidence base on how to diagnose and or treat long COVID is only developing at the moment. As a result, countries differ in how they define long COVID, with most guideline recommendations noted to be conditional or based on expert opinion. As more evidence is published, the approaches to treatment and management may change.
In Ireland, the HSE’s interim model of care for long COVID proposes a three-pillar approach:
- Patient-led rehabilitation and recovery
- General assessment, support and rehabilitation
- Specialist assessment, support and rehabilitation.
Dr Máirín Ryan, HIQA’s Director of Health Technology Assessment, said: “We found that most guidelines are recommending a holistic, person-centred approach to diagnosis, management and treatment, with an emphasis on shared decision-making, which is consistent with the HSE’s interim model of care. It’s clear from this international review that we are at an early stage of understanding long COVID and that the recommendations will change as more evidence becomes available particularly in relation to safe and effective treatments.”
Long COVID has affected many people; in October, the United Kingdom estimated that 3.5% (approximately 2.3 million individuals) of the population were living with long COVID, with about one in five having symptoms for over two years.
Read the review on www.hiqa.ie.