GPAtlas🧭 When to suspect (acute COVID-19 and long COVID)
Suspect acute COVID-19 in anyone with an acute respiratory illness – classically fever, a new continuous cough, or a change in or loss of smell or taste. In practice, presentations now overlap heavily with other winter viruses, and many cases are mild or atypical (sore throat, coryza, headache, myalgia, fatigue or gastrointestinal upset). A positive PCR or lateral-flow test is not required to make a clinical diagnosis.
The two practical tasks in primary care are quite different. In the acute phase, the time-critical job is to identify the small highest-risk group who qualify for an antiviral and get them assessed within days. In anyone whose symptoms persist beyond 4 weeks, think long COVID – but only after serious or alternative disease has been considered and excluded.
| Phase | Definition |
|---|---|
| Acute COVID-19 | Signs and symptoms of COVID-19 for up to 4 weeks. |
| Ongoing symptomatic COVID-19 | Symptoms from 4 to 12 weeks. |
| Post-COVID-19 syndrome | Symptoms continuing 12 weeks or more, not explained by an alternative diagnosis – often fluctuating and multi-system. |
The umbrella term “long COVID” covers both ongoing symptomatic COVID-19 and post-COVID-19 syndrome (i.e. symptoms from 4 weeks onward).
Source: NICE NG191 · NICE NG188
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