Persistent Covid-19: First Clinical Guideline

The Covid-19 pandemic has caused the worst health crisis of this century. The magnitude of the population that continues to struggle with symptoms four weeks after suffering it -commonly called “persistent covid” – it is becoming more and more evident and demands urgent prioritization to avoid a new blow to health systems and personnel.

Persistent Covid occurs in approximately 10% of people infected, so it is likely that currently more than 5 million people affected worldwide. The National Institute for Health and Care Excellence (NICE) and the Royal College of General Practitioners (RCGP) have developed a first clinical guide for the management of the long-term effects of Covid-19, which will be updated regularly as new evidence emerges. This approach is essential, as the current guidance lacks important details, including an exhaustive list of organ complications seen in patients with persistent covid.

The current guidance defines persistent Covid as “the signs and symptoms that develop during or after an infection consistent with Covid-19 and that continue for more than four weeks and are not explained by an alternative diagnosis. “As we are beginning to understand the immunological effects of SARS-CoV-267, according to NICE, it might have been better to define it as” signs and symptoms that continue for more than four weeks and that can be attributed to Covid-19 infection. “This definition would include all post-acute medical complications of coronavirus under a unified definition rather than making persistent Covid a vague diagnosis of exclusion.

Persistent Covid: symptoms beyond four weeks

NICE recommends using the term “post-covid syndrome” from 12 weeks after infection. However, there is no evidence of any particular physiological change at 12 weeks, so it would be preferable to use the term “persistent covid” for symptoms of any duration beyond four weeks. The use of the prefix “post” implies that the acute infection and any active disease processes have been resolved, which is currently unknown.

The guide includes people with suspected covid-19 infection no need for a positive antigen or antibody testas any other approach runs the risk of overlooking the many thousands of people who did not have access to testing in the early phases of the pandemic. In the next update, priority will be given to how to detect, diagnose and treat medical complications reported in patients with persistent covid, including cardiac, respiratory, kidney, liver, gastrointestinal and neurological abnormalities and endocrine problems. In addition, multidisciplinary clinics, led by a physician with relevant expertise and experience, are also recommended to avoid multiple referrals to different specialists.

Finally, this guide produced by NICE recommends that more research be conducted to better understand the common groups of symptoms, risk factors, prognostic markers and the trajectory of persistent Covid for identify effective interventions for all age groups.


Although it may contain statements, data or notes from health institutions or professionals, the information contained in Redacción Médica is edited and prepared by journalists. We recommend that the reader be consulted with any health-related question with a healthcare professional.

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