Long COVID and breathlessness: an overview
This article offers a review of what is known so far about post-acute covid-19 and the underlying pathophysiology related to this condition. The main focus will be on the respiratory symptoms. It will then explore how community nurses can monitor and support patients with symptoms of breathlessness with a supporting discussion of the current recommendations for the management and treatment of patients presenting with symptoms of breathlessness. Palliation of symptoms will be highlighted but managing the supportive care needs for patients affected by COVID-19 and nearing the end of life is outside the scope of this article.
Approximately 10% of individuals who test positive for the SARS-CoV-2 virus remain unwell after the first 3 weeks, and a smaller number continue to be symptomatic with a diverse range of symptoms persisting for over 12 weeks (Greenhalgh et al, 2020). The National Institute for Health and Care Excellence (NICE) outlines that anyone with symptoms lasting more than 4 weeks after an acute presentation of COVID-19 and anyone with persistent symptoms continuing more than 12 weeks are considered to have post COVID-19 syndrome (NICE, 2020). The diagnosis of post-acute COVID-19 should not depend on patients having a confirmed diagnosis of acute COVID-19. The term ‘long COVID’ is synonymous with post-acute COVID-19 syndrome, and it is now a recognised term in the scientific literature.
A significant number of people continue to exhibit a wide range of symptoms following the acute infection stage. The five key long-term symptoms that have been identified are breathlessness, cough, fatigue and muscle and joint pain. The present article focuses on exploring what is known about the persistent breathlessness related to post-acute COVID-19.
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