I was feverish, soaked with sweat to the point of having to regularly towel myself down, and with a persistent headache that had no relief in spite of increased doses of paracetamol or ibuprofen. For the next 72 hours, I felt unwell in a way that was bordering on not coping. This happened very quickly and without warning, resulting in me heading for bed immediately as I felt so bad. I continued to feel like this for another three weeks, before finally feeling completely overwhelmed. Exercise, of which I do a fair amount, was not at all possible. From this point onwards, it became difficult to engage fully in day to day activities with my normal energy levels. The only person whose symptoms persisted was myself, and the fatigue which I had experienced was still lingering in the background. They were soon fine, but I was more unwell and ended up in bed extremely fatigued, lethargic, and without appetite for four days. My wife, kids, and I all had symptoms of presumed covid-19 in early April 2020. The specialist rehabilitation needs of a third group, covid-19 patients whose acute illness required intensive care, have been covered elsewhere. Broadly, such patients can be divided into those who may have serious sequelae (such as thromboembolic complications) and those with a non-specific clinical picture, often dominated by fatigue and breathlessness. 2 This article, intended for primary care clinicians, relates to the patient who has a delayed recovery from an episode of covid-19 that was managed in the community or in a standard hospital ward. 1 Clinical management requires a whole-patient perspective. Post-acute covid-19 (“long covid”) seems to be a multisystem disease, sometimes occurring after a relatively mild acute illness. Indications for specialist assessment include clinical concern along with respiratory, cardiac, or neurological symptoms that are new, persistent, or progressive Home pulse oximetry can be helpful in monitoring breathlessness Many such patients recover spontaneously (if slowly) with holistic support, rest, symptomatic treatment, and gradual increase in activity

Management of covid-19 after the first three weeks is currently based on limited evidenceĪpproximately 10% of people experience prolonged illness after covid-19

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