Long COVID

The name ‘long COVID’ was first coined by patients struggling with prolonged symptoms after coronavirus disease (COVID-19) infection. It emerged formally as a clinical entity early in the COVID pandemic, and although hospitalization from the virus has dramatically declined, the incidence of long COVID remains high, affecting an estimated 2 million people in the UK in 2024 according to the Office for National Statistics. Symptoms are diverse, can fluctuate, vary in nature and emerge after mild or severe infection. Fatigue, cognitive dysfunction (brain fog) and breathlessness are major symptoms, although many more are described. These symptoms often impact daily functioning and can limit a return to work. The condition is heterogeneous and the pathophysiological mechanisms remain elusive; however, they are complex, multifaceted and likely to overlap with myalgic encephalitis/chronic fatigue syndrome. There are no currently available approved pharmacological treatments and management is supportive, focusing around rehabilitation strategies. This chapter provides an overview of the presentation, diagnosis and management of long COVID, highlighting the importance of a holistic, multidisciplinary approach to care.