How GPs can support patients with 'long COVID'

GPs must be ready to support patients with physical, psychological and social problems after COVID-19 infection over a recovery period that could last weeks or months, according to respiratory expert GP Dr Steve Holmes.

(Photo: Courtney Hale/Getty Images)
(Photo: Courtney Hale/Getty Images)

In a free webinar for healthcare professionals on MIMS Learning, Dr Holmes highlighted that recovery may take weeks or months, and that patients may experience a wide spectrum of post-COVID issues - including chronic fatigue, lung and heart problems, and neuropathy from the virus or from being 'proned’ during hospital stays.

He said: 'There will be an awful lot of work for primary care in this, but we can make a good job of it. The implications are physical, psychological and social… As long as we can get patients to understand that natural history, to understand that we can provide that gentle rehabilitation going forward, we should be able to get most of our patients back to normal realistically.’

Dr Holmes said that with 'positivity' and with the help of colleagues such as physiotherapists, hospital specialists, and psychologists, GPs 'should be able to help most of our patients fully recover and those that don’t fully recover, absolutely optimise the care they can get’.

Recovery times

He said recovery times for COVID-19 could be similar to those seen with pneumonia, with symptoms taking up to six months to fully resolve, or more if the patient has had a complicated ICU stay.

He added that a considerable number of those who have had COVID-19 have had physical complications including heart failure, coagulopathy, deep vein thrombosis, renal disease, neuropathy, and interstitial lung disease.

Chronic fatigue syndrome is also common in people who have had viral respiratory infections and is something for GPs to watch out for, he said.

Post-intensive care syndrome may occur amongst the most severely affected, who have been to ICU. They may have ICU-acquired weakness, a neuromuscular condition that develops during an ICU stay and that make activities of daily living difficult.

Other issues include tracheostomy wounds, dysphagia linked to intubation, urological symptoms associated with catheterisation, pressure ulceration and proning plexopathy/neuropathy.

Post-COVID problems

Cognitive dysfunction and mental health problems may also occur after ICU stays. 30-80% of patients may have problems remembering, concentrating, organising and working on complex tasks.

Around 300,000 people in the UK have reported symptoms lasting for more than a month, according to King’s College London team behind the Covid Symptom Study app. The team told a recent Radio 4 investigation that as many as 60,000 people have been ill for more than three months.

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