Long Covid: Care Staff Guide to Post-Covid Symptoms and Support

Long Covid has become a familiar term, but for the people living with it, and the staff who support them, it is anything but routine. Symptoms can be unpredictable, fluctuate from day to day, and affect energy, thinking, breathing and mood. For care workers, understanding long Covid helps you avoid dismissing someone as lazy, anxious or simply getting older. This guide, based on NHS and NICE guidance, explains the condition, what happens when someone seeks help and how to support recovery safely.

What is long Covid?

The NHS describes long Covid as symptoms that continue or develop after the initial COVID-19 infection and last longer than 12 weeks. The NICE rapid guideline NG188, developed with the Scottish Intercollegiate Guidelines Network and the Royal College of General Practitioners, covers adults, children and young people with new or ongoing symptoms four weeks or more after the start of acute COVID-19. NICE updated the guideline in November 2021 with new recommendations on identification, care planning, multidisciplinary rehabilitation, follow-up and service organisation, and noted that symptoms may look different in children.

Common symptoms

The NHS lists the most common symptoms as extreme tiredness (fatigue), shortness of breath, joint pain and aching muscles, and problems with memory and concentration, often called brain fog. Other symptoms include:

• fever, cough and sore throat
• chest tightness and palpitations
• headaches and dizziness
• insomnia
• changes in the senses, such as smell or taste
• stomach problems, loss of appetite and weight loss
• pins and needles
• hair loss or skin rashes
• anxiety or depression

The NHS notes that symptoms can improve, fluctuate or be joined by new ones, and that stress or increased activity may make them worse. In older people, it also lists sudden confusion among the possible symptoms. In a care setting, new confusion is a red flag that needs prompt assessment for delirium and other causes, so use a structured approach such as the 4AT delirium screening tool and escalate quickly.

When and how to get help

The NHS advises people who think they may have long Covid to see their GP. At the appointment, the GP will ask about symptoms and how long they have lasted, and may check blood pressure, heart rate and blood oxygen levels and arrange blood tests. The person may be asked to keep a symptom diary to spot what helps or worsens things, and may be referred for tests such as an ECG or chest X-ray, or to a post-Covid syndrome service. Care staff can help by supporting the person to keep a diary, by writing down symptoms they have noticed, and by attending appointments if the person wants them to.

Some symptoms are urgent. Call 999 for severe breathlessness, chest pain, collapse, signs of a stroke, or if someone is unresponsive, as you would for any emergency.

Treatment and support

The NHS states that there is currently no cure for long Covid, but treatments can ease symptoms. A team of healthcare professionals helps with physical and mental health and builds a personalised plan. Options the NHS lists include:

• advice on managing fatigue
• physiotherapy
• cognitive behavioural therapy (CBT)
• cognitive rehabilitation for memory and concentration
• help with changes to the sense of smell
• diet and nutrition support
• symptom-tracking apps
• social prescribing
• peer support through local or online groups, including national charities such as Long COVID SOS and Asthma and Lung UK

Everyday self-care

The NHS offers practical self-care suggestions that care staff can reinforce:

• set recovery goals with the specialists involved
• keep a diary of triggers
• keep a consistent sleep and wake schedule
• move regularly or take short walks, stopping if symptoms appear
• eat a balanced diet
• use paracetamol or ibuprofen for muscle pain, and ask a pharmacist for advice
• talk to the GP and employer about difficulties at work

The NHS also advises people not to restart exercise before speaking to a GP or specialist. This matters because pushing too hard can make some people feel worse. If someone's care plan includes graded activity, follow it exactly, and tell the clinician if exertion seems to cause a setback that lasts for days.

Fatigue and its overlap with other conditions

Many people with long Covid experience profound, unrefreshing fatigue, and some also meet the criteria for other conditions. Our guide to ME/CFS and NICE NG206 explains how fatigue that is made worse by exertion should be recognised and managed, and the principle of avoiding overexertion applies equally here. Support people to balance activity and rest, break tasks into smaller steps, and plan the most demanding tasks for the time of day when they usually feel best.

Mental health and wellbeing

The NHS lists anxiety and depression among the symptoms of long Covid. Living with an uncertain recovery, reduced independence or changes in work can take a toll. Be alert to low mood, hopelessness, sleep problems and withdrawal, and raise concerns with the GP. Our guide to depression screening in older adults explains how to recognise and respond to low mood in care settings. Listening, believing the person and not minimising their symptoms are among the most helpful things staff can do.

Supporting people at work and home

Where someone is a colleague or is in work, adjustments such as phased returns, flexible hours, rest breaks and reduced multitasking can help. For people receiving care, adapt routines, reduce unnecessary effort, and keep an eye on appetite, weight and hydration.

Frequently asked questions

How long does long Covid last?

The NHS describes it as symptoms lasting longer than 12 weeks. Recovery varies between individuals, and symptoms may improve, fluctuate or change over time.

Can children have long Covid?

Yes. NICE guideline NG188 applies to adults, children and young people, and notes that symptoms may differ in children.

Is there a test for long Covid?

The NHS describes assessment by a GP, with tests used to check for other causes and to monitor the person's health, rather than a single test that confirms long Covid.

Keep building your knowledge

Recognising and responding to long-term conditions with compassion helps people stay safe and supported. Explore the health and social care learning available through Learnsignal CPD to keep your knowledge current.

This article is general information for care staff, based on published NHS guidance, and does not replace the advice of a person's own clinicians.