Post-COVID Referral Guidance

There is currently no pan-Lothian post-covid referral service.

All acutely unwell patients should be assessed via A&E or the Flow Centre.

Alternative Referral Options:

Patients should be referred to the appropriate specialty depending on their symptoms and signs (e.g. respiratory, cardiology, neurology). In addition to the below, please check the relevant specialty RefHelp pages for alternative referral pathways.

• Patients with ongoing fevers >38^oC or symptoms of infection of more than 3 weeks duration, documented in a temperature diary, where no other explanation for the fever is apparent, especially if the patient is immunocompromised, please refer to Infectious Diseases
• Post covid breathlessness including when pulmonary embolism is suspected; respiratory pathway https://apps.nhslothian.scot/refhelp/Respiratory/post-covid-breathlessness
• Patients with breathlessness, tachycardia, or reduced exercise intolerance can be referred for a 12 lead ECG initially. If this is abnormal an echocardiogram can be requested directly, (see referrals for echocardiography)
• Patients with persistent tachycardia can be requested to have ambulatory monitoring (see Direct Access Ambulatory ECG)
• For further cardiology information post covid please see cardiac investigations for breathless patients page
• Patients with symptoms more suggestive of a possible cancer diagnosis (such as lymphadenopathy or unexplained weight loss) should be urgently referred via the appropriate USOC Sci Gateway pathway see http://www.cancerreferral.scot.nhs.uk/Home. GPs can refer directly for CT scan of the chest / abdomen / pelvis for those with non-specific features concerning for malignancy https://apps.nhslothian.scot/refhelp/Oncology/gp-access-to-ct-for-suspected-cancer-(no-clinically-obvious-primary)  
• GP Practices within the pilot scheme can refer to the Digital Support Service for Long Covid

This page has been produced by Referrals Advisor CW without Specialty input 02-10-2023.