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Post COVID Syndrome – Long COVID – GP Referral

  

Most patients with COVID 19 fully recover, but some patients may go on to have a variety of persistent symptoms referred to as Post COVID syndrome or formerly Long COVID


Referral Update October 2021

Kind Reminder: Use of the UHCW Long Covid Assessment Clinic

UHCW colleagues continue to work actively to manage the waiting times for Long / Post-covid screenings and assessments, including for GP clinic referrals.

They have noted that a small, but growing, number of GP referrals are now presenting where Long Covid is not the primary indication eg referral seeking to gain quicker access to rheumatology review.

The Long Covid Assessment Clinic is only for suspected Long Covid cases where other possible causes have reasonably been excluded.  The Assessment Clinic has reasonable access to a Respiratory Consultant but is otherwise delivered by an MDT of therapists with Psychology support.

Referrals for other reasons will likely simply add unnecessary delay and inconvenience to the patient’s experience.

If useful, the Advice and Guidance function remains an option – see the Long Covid section of the GP Gateway

Post COVID Syndrome – Suspected or confirmed COVID-19 with persistent respiratory symptoms AFTER 12 WEEKS

Most patients with COVID 19 will fully recover, but some patients may go on to have a variety of persistent symptoms.

Long COVID / COVID Syndrome is defined as presence of ongoing symptoms after COVID 19 not explained by other reasons 12 weeks after the initial infection.

Common symptoms:

Shortness of breath

Fatigue and tiredness

Mental health issues

UHCW Post COVID MDT Clinic (Respiratory)

Has support from Respiratory Medicine, Endocrinology and  Physiotherapy

Access to other specialist services e.g. Cardiology, Rheumatology, Neurology etc if required.

Fatigue and tiredness can be due to many other reasons and only those patients with new onset symptoms where all the other causes have been ruled out may be referred and seen by the Endocrinology Team

UHCW Patient Follow-up

UHCW will follow-up local patients admitted for COVID-19 at around 6 weeks post-discharge.

The following guidance is particularly for patients with suspected Post COVID Syndrome not known to UHCW.

Primary Care Assessment and Referral

This guidance is particularly for patients with suspected Post COVID Syndrome not known to UHCW.

Inclusion Criteria

History of persistent symptoms 12+ weeks after onset, compatible with suspected COVID 19

Chest X-ray

COVID antibodies test if no vaccination or previous confirmed swab – (Yellow topped bottle)

If COVID is confirmed (previous swab or antibody test) request bloods:

  • Full blood count
  • U&Es
  • Liver Function Tests
  • Vitamin B12
  • Folic Acid
  • Ferritin
  • Vitamin D
  • TSH
  • BNP
  • HbA1c
Urgency of Referral
Patients with confirmed COVID 19 swab or positive antibodies and persistent CXR changes e.g. consolidation / interstitial lung disease / fibrosis Urgent MDT referral
Patients with positive antibodies and normal CXR Routine MDT referral
Patients with negative antibodies and normal CXR Consider A&G or routine Respiratory Medicine referral

 

Referral Letter Information

Please refer through Referral Support Service (RSS)

Include the following and send with the MDT referral letter:

  • CXR report
  • COVID antibody or previous positive swab result
  • Bloods: Full blood count, Urea and electrolytes, Liver Function test, Vitamin B12, Folic Acid, Ferritin, Vitamin D, TSH, BNP, HbA1C

Click on image below or link on RIGHT for downloadable referral form

MDT Clinics & Patient Choice

Post COVID-19 appointments will be mostly face-to-face but patient or clinical need might indicate the need for other forms of clinical review, e.g telephone or video call.

If patient would prefer not to come to hospital for first consultation please add this information in your referral in order for us to arrange a phone consultation.

Please make your patients aware of the following information:

They may receive multiple letters including;

  • Respiratory physiology (breathing test)
    Radiology (CT scan)
    Clinic appointment (if they are booked at short-notice our team will phone them)
  • We will book a blood test on the same day of their appointment in clinic if further tests are needed. They will be given the forms on arrival to clinic or by post.
  • Invitation to participate in clinical trials.
  • Referral to other specialities if needed, e.g cardiology, rheumatology, psychology, neurology.
Advice and Guidance

Please send any A&G requests for the attention of Dr B Lara or Dr A Ali.

See links

 

Follow image above for link to Post Covid Pathway GP Gateway Page including:

Referral form

IAPT information for GPs inc new virtual/remote offer

IAPT information for patients

Patient leaflets:
– Breathing
– Breathlessness
– Cough suppression
– Nutrition
– Prone position
– Voice recovery

Long Covid Support Group

The aim of this group is to provide emotional and wellbeing support and it is not to offer medical advice.

We will be offering room for participants to explore with others the feelings and adjustments necessary for them at this time

Click on this link for Warwickshire Long Covid Support Group information

Please find attached the welcome pack which will be given to participants once referred as shares some details about the group.

Advice for Health Professionals on Returning to Work

 

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