This is defined as symptoms persisting 12 weeks or more
after the onset of the first symptom (4). Although lungs are
considered the main target organ of COVID-19, the virus can affect many other
organs, including heart and blood vessels, kidneys, gut and brain through other
mechanisms (6). Gut symptoms and fatigue may be associated with the psychological and
physical processes of having suffered COVID-19, which does not mean that it is
Comfort eating may be an issue due to low energy, low mood
and anxiety after having overcome the acute phase of COVID-19. Be sensitive to
terms which may be associated with mental health. Avoid dismissing patients
thinking that healthcare professionals hold all answers.
Symptoms of ongoing
and post COVID-19 syndrome (1, 4), which are related to nutrition, are:
- systemic and musculoskeletal: fatigue, post-exertional
malaise and pain
- neuropsychiatric: sleep disturbance and dizziness. Emotion and mood (anxiety).
- gastrointestinal: nausea, diarrhoea, anorexia
and reduced appetite.
- cardiovascular: breathlessness, myalgia and
cough – myocardial injury is the most common complication, thus self-monitor
blood pressure and pulse oximetry may help.
- genitourinary and endocrine: liver disfunction
and symptoms related to urinary function.
Low and high blood glucose levels may also be common.
Further information can be found:
No nutritional screening questionaries have been validated
to identify nutritional issues in COVID-19. However, the suggested questionnaire – the COVID-19 Yorkshire Rehab Screen Tool (2, 4) – available from the Advances in Clinical Neuroscience and Rehabilitation website, could be used at the initial consultation as well as to measure progress.
The questionnaire can also be completed by the patient, allowing them to
self-monitor if appropriate, its scope covers:
with COVID-19 symptoms who have been managed at home. Symptoms may include:
fatigue, breathlessness, cough, low physical strength, anosmia, lost sense of
taste, sleep disturbance, low mood, anxiety, weight loss (>3 kg) or other
adults. When investigating possible causes of a gradual decline,
deconditioning, worsening frailty or dementia, or loss of interest in eating and
drinking in older people, bear in mind that these can be signs of ongoing
symptomatic COVID-19 or suspected post-COVID-19 syndrome.
The questionnaire tool aims to identify breathlessness,
airway complications, swallowing, fatigue, continence, anxiety, depression,
family/carers views are influenced by or can influence nutrition. Regarding
nutrition alone, some questions that this tool asks and that can be used alone
to assess affectations at a nutritional and dietary level are:
- Are you or your family concerned that
you have ongoing weight loss or any ongoing nutritional concerns as a result of
COVID-19? Yes ☐ No ☐
- Please rank your appetite or interest
in eating on a scale of 0-10 since COVID-19 (0 being same as usual/no problems,
10 being very severe problems/reduction)