Intended for healthcare professionals

Letters Covid-19: “Just stay at home”

Long covid: doctors must assess and investigate patients properly

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4583 (Published 02 December 2020) Cite this as: BMJ 2020;371:m4583
  1. Amali U Lokugamage, consultant obstetrician and gynaecologist and honorary associate professor12,
  2. Mary-Ann Bowen, general practitioner3,
  3. Jennifer Blair, consultant anaesthetist4
  1. 1Whittington Health NHS Trust, London, UK
  2. 2UCL Medical School, London, UK
  3. 3Church Street Surgery, Kidderminster, UK
  4. 4Epsom and St Helier University Hospitals NHS Trust, Sutton, UK
  1. a.lokugamage{at}ucl.ac.uk

Jensen’s article provides a poignant patient perspective and reflects well the experiences of many patients that were very sick at the peak of the first wave of covid-19 but were denied proper medical assessment and told to “stay at home.”1 Of course it is important to “show you care” and empathise with the patient. But, as part of an online group of over 500 doctors (ever growing in number) affected by long covid, we are disappointed that the learning points don’t include “doctors should assess and investigate patients properly.” Before the covid-19 pandemic, symptoms such as low oxygen levels, tachycardia, and shortness of breath would warrant examination and investigation, especially when persistent and in previously fit and healthy patients.

It saddens us to hear such low expectations from general practice and secondary care. This is a new disease, and we are surprised about the lack of professional curiosity to explain new and sometimes seemingly odd symptoms. Numerous BMJ publications support the need for further assessment.234 Pathological consequences such as myocarditis5 or a thromboembolic episode6 may explain symptoms, and these have been noted to occur months after onset in long covid support groups. The medical profession needs to evolve rapid transformative pathways to deal with the long term sequelae of covid-19 that include full investigation of patients. This is becoming urgent, as new covid cases are increasing again and we are already starting to see a new wave of patients with long covid.

Footnotes

  • Competing interests: None declared.

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References

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