A summary of guidance for GPs and patients
This information is sourced from the Faculty of Sports and Exercise Medicine , the BMJ and Your Covid Recovery:
Guidance for GPs:
The following patient groups need examination +/- investigations in primary care:
- People who have had severe Covid-19
- Patients with ongoing symptoms (respiratory, GI, rheumatological or psychological)
- Patients with a history suggestive of cardiac involvement (chest pain/palpitations, severe breathlessness or syncope)
This is to determine whether they can returning to physical activity or should be referred to a long Covid rehabilitation service.
People with a history suggestive of cardiac involvement should be considered for cardiology review. They may have had viral myocarditis which requires three to six months of exercise restriction.
Guidance for patients:
- Only return to exercise (or any strenuous physical activity) after at least seven days free of symptoms
- Begin with at least two weeks of minimal exertion
- Then increase levels of exertion each week, and aim to gradually return to your baseline level of exercise over five weeks (but drop back a level if you are finding it difficult at any stage)
- Use daily self monitoring to track progress, including when to seek further help
Additional guidance for athletes:
- Athletes who have more complicated infections or a requirement for secondary care support will need to have a medical assessment before returning to exercise
- Athletes should wait until they have had a minimum of 10 days rest from sport AND have been symptom free for seven days before resuming any exercise other than walking or activities of daily living
- The Faculty of Sports and Exercise Medicine have produced a progressive exercise programme called the Graduated return to play protocol (GRTP)
- Before considering a GRTP, the athlete must be able to complete all activities of daily living without excessive fatigue and/or breathlessness and walk a minimum of 500m on the flat without getting breathless
- Seven days is the minimum time to progress, especially in sports of an aerobic nature
- All treatments should have stopped that may mask symptoms, eg, paracetamol
- Exercise and progression should cease if concerns are raised
