Support Alert

Supporting patients with Long Covid

NICE and SIGN have announced they will work with the Royal College of General Practitioners (RCGP) to develop a guideline on persistent effects of Covid-19 (Long Covid) on patients. Further information on the development of these guidelines can be found on the NICE website

What we know about Long Covid:

Long Covid affects approximately 60,000 people in the UK and is characterised by persistent and fluctuating fatigue, breathlessness, cognitive blunting (“brain fog”) and pain. The cause of Long Covid is unknown, but it is thought to be due to an inflammatory reaction. Most patients get better slowly over time, but perhaps 10% are left with significant organ damage and their long-term outlook is unknown.

Below is a table of some of the body systems that can be impacted by Long Covid.

Body system


Mental health

Anxiety, depression, post-traumatic stress disorder and sleep disturbance. 

Musculoskeletal & other

Pain in joints and muscles, body aches and fatigue.

Brain & Nervous system

Loss of sense of smell (anosmia) which can result from thrombo-embolic events such as pulmonary embolism, heart attack, stroke.

Cognitive impairment (e.g. memory and concentration).



Damage to heart muscle or heart failure. 


Damage to lung tissue and restrictive lung failure.












How pharmacy teams can support in the interim:

Pharmacy teams can support patients exhibiting symptoms of Long Covid by:

  • Offering advice on using medicines correctly and as recommended by prescribers.
  • For symptoms of anxiety, depression and sleep disturbances- advice on sleep hygiene, techniques on managing stress and anxiety. NHS stress can be a useful resource to signpost to.
  • Advice on management of joint pain and body aches.
  • Offering healthy living advice.
  • Signposting to support groups such as the Long Covid Support group  
  • Support for Rehabilitation Self-Management after COVID-19- Related Illness .The leaflet assists in self-rehabilitation and recovery management, addressing the common residual COVID-19 symptoms, specifically breathlessness, starting exercise, getting back to functional activities and mental health.
  • Recognising and referring symptoms that require further investigation.  

Referral Criteria

Although not an exhaustive list, some symptoms can require referral for further investigation, these can include:

  • Severe symptoms of depression, anxiety or stress, or symptoms that are not managed through self-management advice.
  • Impaired cognitive function.
  • Patients memory, thinking, or tiredness are not improving, making it very difficult for them do daily activities.
  • Confusion.
  • Symptoms of heart or lung failure.

Other resources for understanding Long Covid

CDC Long-Term Effects of COVID-19

WHO What we know about Long-term effects of COVID-19


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