Symptoms, complications and management of long COVID: a review

TLC Study Group

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Abstract

Globally, there are now over 160 million confirmed cases of COVID-19 and more than 3 million deaths. While the majority of infected individuals recover, a significant proportion continue to experience symptoms and complications after their acute illness. Patients with ‘long COVID’ experience a wide range of physical and mental/psychological symptoms. Pooled prevalence data showed the 10 most prevalent reported symptoms were fatigue, shortness of breath, muscle pain, joint pain, headache, cough, chest pain, altered smell, altered taste, and diarrhoea. Other common symptoms were cognitive impairment, memory loss, anxiety, and sleep disorders. Beyond symptoms and complications, people with long COVID often reported impaired quality of life, mental health and employment issues. These individuals may require multidisciplinary care involving the long-term monitoring of symptoms, to identify potential complications, physical rehabilitation, mental health and social services support. Resilient healthcare systems are needed to ensure efficient and effective responses to future health challenges.
Original languageEnglish
Pages (from-to)428-442
Number of pages15
JournalJournal of the Royal Society of Medicine
Volume114
Issue number9
Early online date15 Jul 2021
DOIs
Publication statusPublished - Sept 2021

Bibliographical note

Funding Information:
OLA receives funding from the NIHR Birmingham Biomedical Research Centre (BRC), NIHR Applied Research Centre (ARC), West Midlands at the University of Birmingham and University Hospitals Birmingham NHS Foundation, Innovate UK (part of UK Research and Innovation), Gilead Sciences Ltd, and Janssen Pharmaceuticals, Inc. OLA declares personal fees from Gilead Sciences Ltd, GlaxoSmithKline (GSK) and Merck outside the submitted work. SEH is funded by the NIHR ARC, West Midlands. SEH is company director of Narra Consulting Ltd. and declares personal fees from Cochlear Ltd. outside the submitted work. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care. ES reports grant funding from Health Data Research UK, Wellcome Trust, Medical Research Council (MRC), British Lung Foundation, the NIHR, Engineering and Physical Sciences Research Council (EPSRC) and Alpha 1 Foundation. MC is Director of the Birmingham Health Partners Centre for Regulatory Science and Innovation, Director of the Centre for Patient Reported Outcomes Research and is a National Institute for Health Research (NIHR) Senior Investigator. She receives funding from the NIHR Birmingham Biomedical Research Centre, the NIHR Surgical Reconstruction and Microbiology Research Centre and NIHR ARC West Midlands at the at the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Health Data Research UK, Innovate UK (part of UK Research and Innovation), Macmillan Cancer Support, UCB and GSK Pharma. MC has received personal fees from Astellas, Takeda, Merck, Daiichi Sankyo, Glaukos, GSK and the Patient-Centered Outcomes Research Institute (PCORI) outside the submitted work. The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care. Other authors declare no competing interests.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was jointly supported by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI) (grant number COV-LT-0013).

Publisher Copyright:
© 2021, The Royal Society of Medicine.

Keywords

  • COVID-19
  • Review
  • epidemiology
  • health service research
  • infectious diseases
  • long COVID
  • persistent COVID-19 symptoms
  • post-COVID-19 syndrome
  • public health
  • respiratory medicine

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