Key messages

• COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as “Long COVID”.
• Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk.
• Long COVID has a serious impact on people’s ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society.
• Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include:

  –

  The need for multidisciplinary, multispecialty approaches to assessment and management;

  –

  Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;

  –

  The creation of appropriate services, including rehabilitation and online support tools;

  –

  Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;

  –

  Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates; and

  –

  Implementing well-functioning patient registers and other surveillance systems; creating cohorts of patients; and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.

Contents

• Acknowledgments
• Foreword
• How do Policy Briefs bring the evidence together?
• Executive summary
• Policy brief
  • 1. Introduction
  • 2. What do we know about Long COVID?
  • 3. Policy and other responses in Europe
  • 4. Implications for policy
• References
• Joint Policy Briefs

Funding:

KK is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and the NIHR Leicester Biomedical Research Centre (BRC) in the United Kingdom.

Declarations of interest:

KK is Chair of the Ethnicity Subgroup of SAGE; KK and MM are members of Independent SAGE, all in the UK.

All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization.

Box

What is a Policy Brief?