NICE issue UK guidelines on long COVID

Simon Collins, HIV i-Base

On 18 December 2020, NICE issued brief guidelines on ‘identifying, assessing and managing’ the long-term effects of COVID-19 in the UK.

Long COVID is also called Post-Acute Sequelae of COVID-19 (PASC), post COVID and long haul COVID.

These guidelines include recommendations for adults, children and young people.

The guidelines also include advice on services to support people with long COVID.

Long COVID is defined in three categories: acute, ongoing symptomatic and a post-COVID syndrome.

  • Acute symptoms that last longer than four weeks.
  • New or ongoing symptoms from 4-12 weeks or more after the start of acute COVID-19.
  • Post-COVID symptoms consistent with COVID-19 that continue for more than 12 weeks and are not explained by an alternative diagnosis.

The risk of developing long COVID is not thought to be linked to the severity of the acute COVID‑19 (including whether they were in hospital).

Potential symptoms include.

  • Respiratory (difficulty breathing, cough, chest pain, palpitations).
  • General (tiredness, fever, pain).
  • Neurological (brain fog, memory, headache, poor sleep, neuropathy, dizziness, delirium).
  • Gastrointestinal (nausea, diarrhea, abdominal pain, anorexia).
  • Musculoskeletal (joint or muscle pain).
  • Psychological/psychiatric (depression).
  • Ear, nose and throat (tinnitus, earache, sore throat and loss of taste and/or smell.
  • Skin-related (rashes).

The guidelines refer to the importance of individualising care, based on involving relevant specialists to manage symptoms. This should ideally be through a multidisciplinary service with a single point of care.

They include research questions based on areas of limited evidence (such as impact of age, sex and ethnicity on long COVID).


The guidelines are for health workers and commissioners.

This means that technically the document does not include information for people who actually have COVID-19.

They do not include specific treatment or management recommendations or address the situation if referral services are not immediately available.

Webcasts from an important 2-day NIH workshop on Long COVID are now online. [2]

An important international community study on Long COVID Community study on long COVID has recently been published as a pre-review draft and will be reviewed in the next edition of HTB. [3]


  1. NICE. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline [NG188]. (html) (PDF)
  2. NIH Workshop. 3-4 December 2020.
  3. Davis HE et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. Pre-review draft. MedRxiv. DOI: 10.1101/2020.12.24.20248802. (27 December 2020).

This report was first published on 2 January 2021.

Links to other websites are current at date of posting but not maintained.