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Living Guide

This living document is produced by the GP medical directors of Londonwide LMCs in collaboration with clinical colleagues within the NHS system in London to guide London’s GP practices to best help our patients.
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Long Covid

Long Covid was defined during a BMJ Webinar as ‘not recovering [for] several weeks or months following the start of symptoms that were suggestive of covid’.

Our summary provides more detail. We will update this as further understanding develops and research evidence becomes available.

Clinical presentation 

  • Profound fatigue is a common symptom.
  • There is a wide range of other symptoms including cough, breathlessness, muscle and body aches, and chest heaviness or pressure, but also skin rashes, palpitations, fever, headache, diarrhoea, and pins and needles.

Clinical course

  • It has a relapsing and remitting nature, but the long term course is unknown.


  • The aetiology is unclear at present but it is thought to be a multi-system disease, sometimes occurring after a relatively mild acute illness.
  • It is estimated that 10% of people experience prolonged illness after Covid-19.

Assessment and initial management 

Local pathways of care

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