"During an arrhythmia, the heart can beat too fast, too slowly, or with an irregular rhythm," they explain. People who think they may be experiencing persistent or long-term effects of COVID-19 infection are advised to contact their GP, who will determine the appropriate course of action. Your doctor will perform a physical exam and review your history of exposure to specific drugs to diagnose drug-related hyperpyrexia. Fatigue, which he describes as "extreme, sometimes debilitating.". 12 percent of long haulers claim they lost weight as a result of their condition. Dysphoria is one of the many mental health related complaints of long haulers, defined as "a state of unease or generalized dissatisfaction with life." "Arrhythmia is caused by changes in heart tissue and activity or in the electrical signals that control your heartbeat," the NIH explains. A high temperature can be caused by: viral respiratory infections, like colds and flu and COVID-19 ear infections gastroenteritis a disease urinary tract infection pneumonia meningitis "This thickened, stiff tissue makes it more difficult for your lungs to work properly. } ); COVID-19 symptoms seem pretty clear. Since a common symptom of Covid-19 is a fever, some concerned folks may be taking their temperatures more often these days. It is known that increased body temperature (BT) is a marker of infection, so temperature provides an essential orientation of health professionals during the COVID 19 disease course . The term simply indicates a situation where blood pressure is rising beyond what's considered normal and acceptable for an individual. Despite the fact that the infection rate continues to drop, for many, the COVID-19 crisis is far from over. John Hopkins Medicine explains that shortness of breath is when you feel like you can't get enough air or your chest is tight. A few months into the COVID-19 pandemic it became clear that not everyone was fully recovering from the highly infectious virus. It can be the result of a variety of factors, including medication or an underlying disease, "often congestive heart failure, kidney disease or cirrhosis of the liver." Full coverage of the coronavirus outbreak. Normal body temperature is typically 98.6F (37C). There are various. This can sometimes produce a severe inflammatory response that can lead to organ damage and failure. As previously mentioned, heart fluctuations are a common sign of long hauler syndrome. The bottom line COVID-19 does not have a temperature range associated with it. Read about our approach to external linking. This is referred to as malignant hyperthermia (sometimes called malignant hyperpyrexia). (2013). C. John Sperati, MD, MHS., a Johns Hopkins expert in kidney health, explains that some people suffering with severe cases of COVID-19 are suffering kidney damagesome who had no underlying kidney problems before they were infected with the coronavirus. Muscle or body aches. COVID-19 is known to wreak damage on the lungs and respiratory system, and according to 16 percent of long haulers, chest pain and discomfort plague them long after the virus is gone. The term has become almost synonymous with long haulers, and it is one of the most common symptoms experienced by them. People who had severe illness with COVID-19 might experience organ damage affecting the heart, kidneys, skin and brain. In adults and children, a temperature of 100.4F (38C) or higher marks a, A viral fever is a high body temperature that accompanies many viral infections. Other COVID-19 symptoms may include cough, runny nose, body aches, headache, sore throat, difficulty breathing, nausea with or without vomiting, diarrhea, loss . These fluctuations happen because human chorionic gonadotropin (HCG), a hormone produced during pregnancy, stimulates the production of T3 and T4. Read on for a list of the most common symptoms to watch forand to ensure your health and the health of others, don't miss this special report: The #1 Cause of Heart Attack, According to Science, Signs You're Getting One of the "Most Deadly" Cancers, I'm a Doctor and Warn You Never Take This Supplement, Women who had ovarian cysts share their stories, A sugar replacement may be linked to heart attacks and strokes, but don't throw it out yet. 7 Tips You Must Follow to Avoid COVID, Say Doctors, Dr. Fauci Just Said When We'd Get Back to Normal, Fatigue is the most common symptom of long and acute COVID-19, experienced by 58 percent of long haulers per the research. The very thing that carries you around the world (your body) has become wild, unpredictable, unrecognizable. Clinical profile of severe malaria: Study from a tertiary care center in north India. If the fever is not lowered, organ damage and death can result. "Many patients with severe COVID-19 are those with co-existing, chronic conditions, including high blood pressure and diabetes. Malignant hyperthermia can be diagnosed by testing a sample of muscle tissue. DOI: Nandwani S, et al. Why are so many people catching Covid again? When should you break a fever, and when should you let it run its course? FACT: Spraying and introducing bleach or another disinfectant into your body WILL NOT protect you against COVID-19 and can be dangerous. Learn more. If you can't stay at home while you feel unwell, you can reduce the chances of passing on the infection you have by: For most people who've been vaccinated - and children, even if they haven't had a jab - Covid infections are usually mild, and typically last for up to a week. The NHS explains: "A high temperature is a symptom of coronavirus. While temperature measurements are widely used for screening Covid-19 patients at the entrances of many office buildings or malls, a new study suggests that a huge spike in resting heart rate is a . That widely accepted number originated from a study done in the mid-1800s . Typically, your average body temperature should be around 98.6 Fahrenheit (or 37 Celsius). A silent hypoxia that progresses rapidly to respiratory failure may explain why some younger Covid-19 patients with no underlying health conditions have died suddenly after not experiencing any . (2011). Sputum is basically thick mucus, aka phlegm, and was reported by 3 percent of those surveyed. COVID-19 is known to wreak damage on the lungs and respiratory system, and according to 16 percent of long haulers, chest pain and discomfort plague them long after the virus is gone. Discontinuous flushing was reported by five percent of long haulers surveyed. In fact, some people, who initially suffered mild to moderate infections, were experiencing curious symptoms several months after the virus had gone away. Health Education England will join us in April 2023. If you feel panic when your thermometer beeps and reads 0.2 degree. Post-COVID-19 syndrome, AKA "PCS," "COVID-19 long-haul syndrome" and "Post-Acute Sequelae of SARS COV-2," is the prolonged version of the virus that millions of people around the world are coping with long after their initial infection. But this is not the case. "Arrhythmia is caused by changes in heart tissue and activity or in the electrical signals that control your heartbeat," the NIH explains. Wenn Sie Ihre Auswahl anpassen mchten, klicken Sie auf Datenschutzeinstellungen verwalten. Current health guidelines advise that anyone with a temperature of 37.8C or more should be considered to be potentially infected with COVID-19 and should self-isolate. Sign up for Yahoo Lifes daily newsletter, American immunologist and head of the U.S. National Institute of Allergy and Infectious Diseases, Despite the fact that the infection rate continues to drop, for many, the. Your COVID Recovery is one element of the five-part package of measures to boost NHS support for long COVID patients. feeling tired or exhausted, lack of energy, avoiding crowded places such as public transport or large indoor gatherings, covering your mouth and nose when you cough or sneeze and washing your hands frequently, people of any age whose immune system means they are at higher risk of serious illness, people of any age with certain long-term conditions, call 111 if you're worried about a baby or child under five, if your child seems very unwell, is getting worse or you think there's something seriously wrong, call 999, don't delay getting help if you're worried, trust your instincts. "New-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19," explained one study surrounding the relationship between the two. Fever (a raised temperature) is a common symptom of COVID-19, affecting more than two thirds of people with the disease. A fever is usually when your body temperature is 37.8C or higher. Another incredibly common long hauler symptom is a coughwhich is also one of the main symptoms of an initial infection. If you have any of these symptoms plus a high temperature or you don't feel well enough to carry out normal activities, you're advised to stay at home in England. And to protect your life and the lives of others, don't visit any of these, 35 Places You're Most Likely to Catch COVID. Mental issues were a common complaint of long haulers. RELATED: Simple Ways to Avoid a Heart Attack, According to Doctors, According to 12 percent of long haulers, the virus manifests itself in skin and dermatological conditions. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. The very thing that carries you around the world (your body) has become wild, unpredictable, unrecognizable. Hyperpyrexia and high fever as a predictor for serious bacterial infection (SBI) in children A systematic review. However, it is just one of many vision related complaints of those who previously battled COVID. You're trying to distract yourself all the time to avoid getting at the root of what's making you feel this way. (2018). Infections that can cause hyperpyrexia include but are not limited to: Sepsis can also cause hyperpyrexia. The Mayo Clinic explains that joint pain often arises as a result of inflammation. You feel irritable and exhausted, like your mind is constantly spinning and you can't concentrate. According to the research, 17 percent complained of the sweats. "This is such a common symptom of chronic illness that I dedicated a whole appendix (on top of the existing writing within the chapters) to it in the book. Diarrhea. The new list of Covid symptoms has been expanded from the original three: It now includes nine other symptoms which are common signs of other respiratory infections too: It's not possible to tell if you have Covid-19, flu or another respiratory infection based on symptoms alone, official advice says. The BBC is not responsible for the content of external sites. If you think you might be a long hauler, you should contact your healthcare provider as soon as possible or reach out to one of the regional post-Covid care centers around the country. Mean patient age was 58, 62% were men, and many had underlying illnesses such as high blood pressure (54%), diabetes (33%), coronary artery disease (12%), and heart failure (12%). 42 "Some patients still haven't fully recovered their sense of smell months after they lost it during the initial infection," Dr. Wilson explained. "You feel hot or cold," Dr. Fauci said, explaining the phenomenon of temperature dysregulation. Hyperpyrexia is rare in infants. "New-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19," explained. "Myocarditis can affect your heart muscle and your heart's electrical system, reducing your heart's ability to pump and causing rapid or abnormal heart rhythms (arrhythmias)," they explain. Methods: We conducted a hospital-based case-control study of patients admitted for COVID-19 with prolonged fever (fever >7 days) and saddleback fever (recurrence of fever, lasting <24 hours, after defervescence beyond day 7 of illness). Acute toxic effects of Ecstasy (MDMA) and related compounds: Overview of pathophysiology and clinical management. Normal body temperature seems to be falling over time. Similar to depression, 13 percent of long haulers report experiencing anxiety. Chapter 218: Temperature. While this might be normal after a workout or period of exertion, post COVID shortness of breath can occur at any timeeven when laying in bed or sitting on the couch. Thyroid storm is a rare condition that can occur when thyroid hormones are overproduced. According to the survey, over one in five surveyed reported post-activity polypneaa difficulty breathing after exertion. if( 'moc.sihttae.www' !== location.hostname.split('').reverse().join('') ) { According to this research, about 1 percent of long haulers report kidney failure. "Many people might not recognize how serious this is, but without smell people may not eat as well, may inadvertently expose themselves to contaminated food, and, more broadly, life just feels less colorful. Do you have long COVID? Pink eye is an uncommon symptom of COVID-19. You can't sleep, or when you do, you have nightmares. Hall AP, et al. Symptoms of COVID-19 may appear 2-14 days after exposure to infection. (2008). The BBC is not responsible for the content of external sites. So how can you tell if you've got Covid, a bad cold or something else? What Is the Normal Body Temperature Range? Klicken Sie auf Alle ablehnen, wenn Sie nicht mchten, dass wir und unsere Partner Cookies und personenbezogene Daten fr diese zustzlichen Zwecke verwenden. . People with symptoms are no longer advised to test for Covid in England, but if you do have a positive result, you should try to stay at home and avoid contact with other people for five days . Thepublic facing information website provides general information on all aspects of recovering from COVID-19 including physical, emotional and psychological wellbeing, advice on recovery and information for families and carers. Why Alex Murdaugh was spared the death penalty, Why Trudeau is facing calls for a public inquiry, The shocking legacy of the Dutch 'Hunger Winter'. Health Education England (HEE) e-learning modules: long COVID programme, The Faculty of Occupational Medicine: guidance for return to work for patients with long-COVID, COVID-19 rapid guideline: managing the long-term effects of COVID-19, Long COVID network on the FutureNHS platform, ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from four to 12 weeks. In either case, natural fluctuations in temperature can occur among healthy individuals. Dr. Fauci describes brain fog as "the inability to focus or concentrate over an extended period of time." Nonetheless, researchers encourage "an increase in mental health attention models in hospitals and communities" during and after the COVID-19 pandemic. Our website services, content, and products are for informational purposes only. According to the surgery, 2 percent of long haulers struggle with it. Sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts, according to the Mayo Clinic, is one of the many sleep conditions reported by long haulers. One of the many heart-related symptoms of long hauler syndrome is heart palpitations"feelings of having a fast-beating, fluttering or pounding heart," per the Mayo Clinicreported by 11 percent of those surveyed. The average temperature was 98.0 degrees for men and 98.2 degrees for women. 7 percent of those surveyed reported health care-related mental health issues. It would seem to make sense that the higher your fever, the more unwell you will be. , is one of the many sleep conditions reported by long haulers. According to the Mayo Clinic, edema is swelling caused by excess fluid trapped in your body's tissues. You feel irritable and exhausted, like your mind is constantly spinning and you can't concentrate. Resting Heart Rate Increase. There is no cure but you may find relief from certain symptoms. Periodic fever syndrome is a group of conditions that cause fevers and other symptoms. Bei der Nutzung unserer Websites und Apps verwenden wir, unsere Websites und Apps fr Sie bereitzustellen, Nutzer zu authentifizieren, Sicherheitsmanahmen anzuwenden und Spam und Missbrauch zu verhindern, und, Ihre Nutzung unserer Websites und Apps zu messen, personalisierte Werbung und Inhalte auf der Grundlage von Interessenprofilen anzuzeigen, die Effektivitt von personalisierten Anzeigen und Inhalten zu messen, sowie, unsere Produkte und Dienstleistungen zu entwickeln und zu verbessern. This can include older adults, very young children, or individuals with chronic illnesses. Here's everything you need to know about when and how to break a fever. "They could be related to the direct effect of the infection, cerebrovascular disease (including hypercoagulation), physiological compromise (hypoxia), side effects of medications, and social aspects of having a potentially fatal illness. An infection can cause a fever, but . As pulmonary fibrosis worsens, you become progressively more short of breath," they explain. What supplements should we really be taking? Emerging evidence and patient testimony is showing a growing number of people who contract COVID-19 cannot shake off the effects of the virus months after initially falling ill. Being prone to malignant hyperthermia is hereditary, which means that it can be passed from parent to child. The following are the classifications of body temperature ranges, according to an article in the Journal of Infection and Public Health: . "Adults have a double risk of being newly diagnosed with a psychiatric disorder after the COVID-19 diagnosis," the researchers wrote, noting that 2 percent complained of obsessive compulsive disorders. These readings are therefore an unreliable measure for detection of COVID-19 or other diseases which may . 4 Temperature Dysregulation The surprised girl holds. 4 percent of long haulers reported diabetes mellitus, or a new onset of diabetes. One recent study that looked at 250,000 temperature measurements from 25,000 British patients found the average to be 97.9 F. "A fever alerts you that something is going on and is the way the body . From vegan to keto, which diet has the highest carbon footprint. Conditions such as thyroid storm can be treated with antithyroid drugs. Heatstroke is a serious medical emergency. While many COVID sufferers report a sore or scratchy throat as an initial symptom of the virus, 3 percent of long haulers report that it lingers long after their initial infection. Your body temperature can reveal a lot about your health. Of course you're anxious! In rare circumstances, exposure to some anesthetic drugs can cause extremely high body temperature. Sepsis is a life-threatening complication from an infection. This could have something to do with the stress caused by an infection-related hospitalization. Various severe bacterial, viral, and parasitic infections can lead to hyperpyrexia. ", RELATED: Signs You're Getting One of the "Most Deadly" Cancers, 10 What to Do if You Think You Have Long COVID. Although it can be measured on the forehead, in the mouth, the ear and the armpit, the most accurate way is to take a rectal reading . However, the recent report on asymptomatic contact transmission of COVID-19 and travelers who passed the symptoms-based screening and tested positive for COVID-19 using reverse transcription polymerase chain reaction (RT-PCR) challenges this approach as body temperature screening may miss travelers incubating the disease or travelers concealing explains that viruses and infections can cause sore throats. According to the Mayo Clinic, tinnitus is defined as "ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss." The survey found that five percent of long haulers identified with this severe symptom of long hauler syndrome. What we used to think of as a "normal" body temperature may be outdated. Sponging or bathing in cool water can help lower your body temperature. "This is such a common symptom of chronic illness that I dedicated a whole appendix (on top of the existing writing within the chapters) to it in the book. Malignant hyperthermia (malignant hyperpyrexia) (MH). ", , tinnitus is defined as "ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss." Emerging evidence and patient testimony is showing a growing number of people who contract COVID-19 cannot shake off the effects of the virus months after initially falling ill. The symptoms observed in post-COVID-19 patients, resemble chronic fatigue syndrome (CFS), "which includes the presence of severe incapacitating fatigue, pain, neurocognitive disability, compromised sleep, symptoms suggestive of autonomic dysfunction, and worsening of global symptoms following minor increases in physical and/or cognitive activity," they explain. "The etiology of neuropsychiatric symptoms in COVID-19 patients is complex and multifactorial," the researchers write. Most people can be treated for Covid at home, as with any other mild respiratory illness. The first symptom mentioned by Dr. Fauci? (2017). Several studies have indicated an association with high fever and risk of serious bacterial infection in very young infants. The average body temperature is 98.6 degrees Fahrenheit but varies from 97.7 to 99.5 degrees. If you have malignant hyperthermia, your doctor or anesthesiologist will stop all anesthetic drugs and give you a drug called dantrolene. If you have a relative who has malignant hyperpyrexia, you should consider being tested for the condition. We avoid using tertiary references. "Most times, these people have reasonable blood pressure . Symptoms are wide-ranging and fluctuating, and can include breathlessness, chronic fatigue, brain fog, anxiety and stress. , a Johns Hopkins expert in kidney health, explains that some people suffering with severe cases of COVID-19 are suffering kidney damagesome who had no underlying kidney problems before they were infected with the coronavirus. However this amount can fluctuate slightly depending on the person's age, the time of day and the current activity. Patient safety learning and RCGP resource: Post COVID-19 syndrome: what support can patients expect from their GP? According to those surveyed, 3 percent with the condition claim to have suffered the medical condition that occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Print. Myocarditis is an inflammation of the heart muscle (myocardium), usually caused by a viral infectionincluding COVID-19per the Mayo Clinic. If you have any of these symptoms plus a high temperature or you don't feel well enough to go to work or school, you're advised to stay at home. Your doctor will use your medical history, symptoms, and lab tests to confirm thyroid storm. "We have people that we follow up to nine months or longer," he revealed. , pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. Pain in one form or another was reported by 11 percent of long haulers, per the survey. Sometimes, in some cases, average body temperature can vary between 97.8 degrees to 99 degrees. (n.d.). The CDC recommends calling your doctor if you develop any of the main symptoms, and have been in close contact with an infected person or recently traveled to an area with widespread of COVID-19 . First, the temperature threshold used to determine if a patient has a fever100.4 degrees Fahrenheitmay be inaccurate for some people. Berman BD. Dr. Fauci revealed that the government is "going to be putting together a number of cohort studies to determine the extent, the duration, any possible underlying pathogenesis and any intervention," that can help with long COVID. Per the surveys, 8 percent of respondents reported it. Adults: temperature of 103 F (39.4 C) or higher potentially a sign of serious COVID-19 disease. Feeling dizzy or unbalanced is another neurological manifestation of the virus, reported by 3 percent of respondents. Research published this year suggests that the average human body temperature is a bit lower maybe 97.9. COVID-19 can damage many organs, including the kidneys. "Inflammation attacks joint tissues, causing fluid in your joints, swelling, muscle damage, and more,". Mild-moderate may feel more like the flu or "walking pneumonia": wiped out for days, deep, dry cough, fever . Obsessive Compulsive Disorder (OCD). Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event, according to the NIH. The, explains that joint pain often arises as a result of inflammation. every day. You may feel warm, cold or shivery. Many people will no longer be infectious after five days but some may still be able to pass on the virus for up to 10 days. "Although these findings are not as high as compared to other available studies of survivors with COVID-19 or SARS, where the estimate of lung dysfunction is 53% and 28% respectively, the reasons behind these differences could be distinct follow-up periods, definitions of pulmonary dysfunction, or characteristics of the patient population. A normal body temperature is generally 98.6F (37C), but a person's normal body temperature may vary throughout the day, with lower temperatures occurring in the early morning and higher temperatures in the late afternoon. Fever was defined as a temperature of 38.0C. Preserving brain function in a comatose patient with septic hyperpyrexia (41.6 C): A case report. 6 percent of those surveyed reported psychiatric illness as a symptom. Hyperpyrexia in the emergency department. First published on Tue 11 Jan 2022 08.51 EST. Many experience fatigue, fever, body aches after receiving second dose of Covid-19 vaccine Meg Tirrell reports some people are reporting fever, chills, and body aches after they receive the. "Stress, exercise, medication or, rarely, a medical condition can trigger them," they explain. In children aged three to 36 months, fever generally is defined by rectal temperature ranging from 38 to 39 deg C. If there is no focus of infection when the child is examined, a fever of concern. Fatigue. The New Cases animation uses a 5-day moving average, calculated for each day by averaging the values of that day, the two days before, and the two next days. var xhr = new XMLHttpRequest(); A normal temperature is around 36-37C, although it depends on your age, what you've been doing, the time of day and how you take the measurement. While many COVID sufferers report a sore or scratchy throat as an initial symptom of the virus, 3 percent of long haulers report that it lingers long after their initial infection. "Although edema can affect any part of your body, you may notice it more in your hands, arms, feet, ankles and legs," they explain. Neuroleptic malignant syndrome: A review for neurohospitalists. Hair loss after COVID-19 could be considered as telogen effluvium, defined by diffuse hair loss after an important systemic stressor or infection, and it is caused because of premature follicular transitions from active growth phase (anagen) to resting phase (telogen). updated guidance now lists nine extra symptoms, Nine new Covid symptoms added to official list, Coronavirus loss of smell: Meat tastes like petrol. Tachycardia is "unexplained, rapid heartbeat," and is a common complaint of long haulers, per Dr. Fauci. People often associate shivers with being cold, but they are also a symptom with fever. Nausea or vomiting. According to the surveys examined, 0.3 percent of people suffered from the psychological condition after battling COVID-19. You can also open windows in rooms for 10 minutes after someone with symptoms has left. National Institute for Health Research (NIHR) resources. What constitutes a "normal" temperature for a human being. Assessing people with new or ongoing symptoms after acute COVID-19, Management, including self-management, supported self-management, and rehabilitation, East Suffolk and North Essex NHS Foundation Trust, Essex Partnership University NHS Foundation Trust, Norfolk Community Health and Care NHS Trust, Cambridge University Hospital NHS Foundation Trust, Milton Keynes University Hospital NHS Foundation Trust, Barking Havering and Redbridge University Hospitals NHS Trust, Chelsea and Westminster Hospital NHS Trust, Homerton University Hospital NHS Foundation Trust, London North West University Healthcare Trust, St Georges University Hospitals Foundation Trust, University College London Hospitals NHS Foundation Trust, Epsom and St Helier University Hospitals NHS Trust, Kings College Hospital NHS Foundation Trust, Birmingham Community Healthcare NHS Foundation Trust, Northamptonshire Healthcare NHS Foundation Trust, University Hospitals Coventry and Warwickshire NHS Trust, Derbyshire Community Health Services NHS Foundation Trust, Lincolnshire Community Health Services NHS Trust, Midlands Partnership NHS Foundation Trust, Nottinghamshire Healthcare Trust and Nottingham CityCare Partnership, Sandwell and West Birmingham Hospitals NHS Trust, Calderdale and Huddersfield NHS Foundation Trust, County Durham and Darlington NHS Foundation Trust, Harrogate and District NHS Foundation Trust, Humber Long COVID Triage and Assessment Service, hosted by City Healthcare Partnership, covering Hull University Teaching Hospital and North Lincolnshire and Goole, North Cumbria Integrated Care NHS Foundation Trust, North Tees and Hartlepool NHS Foundation Trust, Northumbria Healthcare NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, York Teaching Hospital NHS Foundation Trust, South Tyneside and Sunderland NHS Foundation Trust, Kirklees Local Post COVID Assessment Clinic, Lancashire and South Cumbria NHS Foundation Trust, Cheshire and Merseyside including, Mersey Care NHS Foundation Trust, Wirral Community Health and Care NHS Foundation Trust, Warrington and Halton Hospitals NHS Foundation Trust, East Cheshire NHS Trust, Cheshire and Wirral Partnership NHS Foundation Trust, Central Cheshire Integrated Care Partnership, Manchester University NHS Foundation Trust, Tameside and Glossop Integrated Care NHS Foundation Trust, Wrightington, Wigan and Leigh NHS Foundation Trust, Ashford and St Peters Hospital NHS Foundation Trust and Central Surrey Health, Oxford University Hospitals NHS Foundation Trust, Royal Surrey County Hospital NHS Foundation Trust, Gloucestershire Health and Care NHS Foundation Trust, Dorset Healthcare University NHS Foundation Trust, Livewell South West, including University Hospitals Plymouth NHS Trust, Royal Devon and Exeter NHS Trust, Northern Devon Healthcare NHS Trust, and Torbay and South Devon NHS Foundation Trust.