LTCcovid Country Profiles
Responses to 2.03. Impact of long COVID among people who use Long-Term Care
The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It is compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project are moderating the entries and editing as needed.
The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.
To cite this report (please note the date in which it was consulted as the contents changes over time):
Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Patel D, Pharoah D (eds.) and LTCcovid contributors. LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science. https://doi.org/10.21953/lse.mlre15e0u6s6
Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.
About this question
With thanks to Kathryn Hinsliff-Smith and Adam Gordon
What is long COVID?
There is no universally agreed definition of long COVID and different studies use varying definitions. Indeed, the World Health Organisation (WHO) highlights that “over the course of the pandemic, various terminology including long COVID, long-haul COVID or the WHO-recommended post COVID-19 condition have been proposed” (WHO 2021). Still, a globally standardized clinical case definition of this condition remains lacking. In the UK the National Institute for Health and Care Excellence (NICE) uses the following set of definitions to distinguish 3 phases following infection consistent with COVID-19, and to define the term ‘long COVID’:
Acute COVID-19 Signs and symptoms of COVID-19 for up to 4 weeks.
Ongoing symptomatic COVID-19 Signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.
Post-COVID-19 syndrome Signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis. (NICE, 2022).
The term ‘long COVID’ is commonly used to describe signs and symptoms that continue or develop after acute COVID-19. It includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and post-COVID-19 syndrome (12 weeks or more) (NICE, 2022). The majority of studies conducted on long COVID are based on either children or adults under the age of 69 as this is known to be the population with the most reported prevalence of long COVID symptoms.
We are not aware of any work that has been conducted on long COVID with regards to pathways, support or management of symptoms with residents in long term care homes or among people receive care and support from others in the community.
NICE (2002) guidance https://www.nice.org.uk/guidance/ng188/resources/COVID19-rapid-guideline-managing-the-longterm-effects-of-COVID19-pdf-51035515742 version 1.13 published on 01.02.2022 accessed 08/02/2022
WHO (2021) https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 6/10/21 accessed 08/02/2022
At present, there is no specific data on the impact of long Covid among people who use Long-Term Care. In July, 2021 the National Health Institute published the national guidelines to assess and manage patients affected by long Covid. The National Government established that people who recovered from severe forms of Covid-19 will have free access to follow up exams for two years (without paying the so-called “ticket” for highly specialized exams).
Istituto Superiore di Sanità (2021). Indicazioni ad interim sui principi di gestione del Long-COVID
Quotidiano Sanità. Long Covid. Il Governo chiarisce in Parlamento modalità di monitoraggio pazienti ed esenzione dal ticket per le visite specialistiche. Published on June, 25th 2021.
Last updated: February 16th, 2022 Contributors: Eleonora Perobelli | Elisabetta Notarnicola |
There is limited data on long-term COVID-19 in Japan as yet but growing interest in it and how it should be managed (Source: https://www.japantimes.co.jp/news/2021/02/07/national/covid-aftereffects-long-lasting/).
Last updated: March 23rd, 2022
It is reported from a survey conducted by the Office of National Statistics (ONS) that about 1.3 million people in the UK have “long COVID” symptoms lasting more than four weeks after an initial infection (ONS, 2022). Of those, 892,000 (70%) first caught the virus at least 12 weeks ago and 506,000 (40%) at least a year ago (ONS, 2022). Some caution is needed as the estimates relate to self-reported symptoms via a survey rather than a clinical diagnosis although for some respondents this might be the case and included only those living in private households and would not include any individuals living in any type of long-term care home setting.
In the UK, there are now established pathways and centres, some 89, for referring patients who are diagnosed as experiencing long-COVID symptoms (NHS, 2021). However, it is unclear if any care home residents are referred to these services since the majority of services are often located in urban settings linked to existing services and are often not easily accessible for those requiring ongoing support needs, such as a carer present. A plethora of studies has been undertaken on numerous aspects of the pandemic on care homes settings (see, LTCcovid database for details). However, we are not aware of studies directly relating to the management of resident symptoms, referral or access to the rehabilitation pathways or if indeed residents are recognised as having long COVID symptoms. This needs to be addressed. We are aware of current work been undertaken, led by Gordon et al., (2022), that is exploring the current rehabilitation pathways which will be considering the pathways for all patients including those living in care home settings.
Gordon, A. et., al. (2022) Protocol: Long-COVID syndrome: understanding how rurality influences design and development of pathways for delivery of sustainable care. Exploratory study in one geographic region.
Office of National Statistics (ONS) (2022) Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK : 3 February 2022
NHS (2021) Long COVID: the NHS plan for 2021/22 . Accessed 08/02/2022
NICE (2022). COVID-19 rapid guideline: managing the long-term effects of COVID-19. Version 1.14 accessed 11/03/2022
Royal College of Nursing (RCN) (2021). Long COVID: what do we know? Retrieved from: https://www.rcn.org.uk/magazines accessed 11/03/2022
Last updated: March 11th, 2022 Contributors: Dr Kathryn Hinsliff-Smith |
Contributors to the LTCcovid Living International Report, so far:
this list is regularly updated to reflect contributions to the report, if you’d like to contribute please email firstname.lastname@example.org
Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Erica Breuer, Jorge Browne Salas, Jenni Burton, William Byrd, Sara Charlesworth, Adelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin Hämel, Nina Hemmings, David Henderson, Kathryn Hinsliff-Smith, Iva Holmerova, Stefania Ilinca, Hongsoo Kim, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’Donovan, Camille Oung, Disha Patel, Martina Paulikova, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. Schmidt, Agnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jae Yoon Yi, Jessica J. Yu
This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.