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Covid-19 Primary Care Resources


When should we refer patients with ongoing breathlessness post Covid-19?



UCLH Respiratory team advice

This information is sourced from Dr Melissa Heightman, Respiratory Consultant, University College London Hospital (UCLH)

Q.     Are there any red flags in patients with ongoing breathlessness post Covid-19 other than the usual ones (chest pain, worsening SOB)?

A.

  • Persistent or worsening breathlessness at 4-6 weeks post Covid-19 should be assessed further with an exercise desaturation test and CXR with bloods such as FBC, CRP, U&E, LFT and possibly d-dimer
  • There is debate regarding how much of this can be done in primary care, versus one stop assessment in ambulatory care, or Covid-19 follow up clinic as it depends on local services
  • There is added benefit to physio assessment to consider breathing pattern disorders which are quite common in this group- plus they can give targeted advice regarding patient initiated rehabilitation
  • At UCLH we are currently accepting direct GP referrals for a one stop assessment (as numbers referred from primary care are low at the moment)
  • Local pathways are currently being developed

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