Box 4.

Recommendations relating to management: general approach (questions 20 to 27)

  • 20. For patients with fatigue and worsening symptoms hours to days following an activity, emphasise the importance of an initial phase of convalescence followed by careful pacing and rest (strongly agree = 27, 82%; agree = 6, 18%; neither agree nor disagree = 0, 0%; disagree = 0, 0%; strongly disagree = 0, 0%).

  • 21. Support patients in shifting their mental timeline of recovery to reflect the likely prolonged course, with a possibly long phased return to work (strongly agree = 24, 73%; agree = 9, 27%; neither agree nor disagree = 0, 0%; disagree = 0, 0%; strongly disagree = 0, 0%).

  • 22. Further support patients with signposting to patient resources. Applicable resources may include: management of post-exertional symptom exacerbation, activity pacing, acupuncture, diagnosis-specific management as relevant (strongly agree = 14, 42%; agree = 16, 49%; neither agree nor disagree = 1, 3%; disagree = 2, 6%; strongly disagree = 0, 0%).

  • 23. Provide patients with signposting to social prescribing, sickness certification, and financial advice. Discuss with the patient whether sickness certification will state long COVID as diagnosis (strongly agree = 26, 79%; agree = 6, 18%; neither agree nor disagree = 1, 3%; disagree = 0, 0%; strongly disagree = 0, 0%).

  • 24. Clinicians should ensure that the occupational status of patients with long COVID is recorded (in/out of work, part-/full-time, student) (strongly agree = 25, 76%; agree = 8, 24%; neither agree nor disagree = 0, 0%; disagree = 0, 0%; strongly disagree = 0, 0%).

  • 25. Follow patients up regularly to monitor progress from a full biopsychosocial and occupational perspective (strongly agree = 19, 58%; agree = 13, 39%; neither agree nor disagree = 1, 3%; disagree = 0, 0%; strongly disagree = 0, 0%).

  • 26. Encourage reporting of new symptoms (expected) and expectation of waxing–waning course (strongly agree = 25, 76%; agree = 8, 24%; neither agree nor disagree = 0, 0%; disagree = 0, 0%; strongly disagree = 0, 0%)

  • 27. Consider contributing patient data to research on long COVID, using the WHO Case Report Form or similar10(strongly agree = 22, 67%; agree = 9, 27%; neither agree nor disagree = 2, 6%; disagree = 0, 0%; strongly disagree = 0, 0%).