Referral

Some complications of Covid-19, even in patients who self-managed at home, are conditions such as lung damage, myocarditis (inflammation of heart muscle) and postural hypotension and these will be expected to cause protracted symptoms, however other unrelated diseases may also emerge (e.g. coronary heart disease). Where a patient with significant symptoms has not already seen or spoken with the GP, they should be advised to do so. 

Long-Covid patients with lung or cardiac symptoms may be given heart-rate monitors or pulse oximeters to monitor their blood oxygen levels at home and may be asked to send the information to their GP between appointments. Guidelines recommend that patients who have continuing respiratory symptoms and have not already had an x-ray are sent for one 12 weeks after having acute Covid-19. Blood tests may be indicated. 

Investigations will depend on the range of symptoms experienced, but red flags include:

• Severe or worsening shortness of breath
• Low oxygen saturation (<94% at rest) or desaturation on exertion
• Unexplained chest pain
• Severe dizziness or syncope (fainting) on exertion
• Palpitations or tachycardia at rest or on minimal exertion
• Focal weakness (e.g. of the face or an arm or leg)
• New confusion or expressive dysphasia (unable to speak coherently).