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This is the third and final article in the Long Covid (LC) series, which presents and discusses the ongoing development of the Leeds Long Covid Community Rehabilitation Service (LLCCRS), highlighting the digital interventions used to assist with symptom management and barriers to overcome to achieve this, the importance of involving people with LC (PwLC) within service development as well as two of the most recent service evaluations of new digital interventions -- virtual group assessments (VGA), and Covid-19 Yorkshire Rehabilitation Scale (C19 YRS) mobile application (app). [ABSTRACT FROM AUTHOR]

This article, the second in a three-part series on Long Covid (LC), focuses on how one community-based NHS LC clinic developed and now delivers a 10-week group-based virtual rehabilitation programme (VRP), which aims to provide persons with Long Covid (PwLC) concepts on current thinking in LC, alongside self-management education and support. It highlights the role of embedded clinical research fellows (CRF), and their role in an in-depth service evaluation of the VRP, using established research methods and being peer reviewed/supervised by a research team to support best practice in an evidence poor field. [ABSTRACT FROM AUTHOR]

This article, the first in a three-part series on Long Covid, provides a definition of post-Covid-19 syndrome and Long Covid. It highlights the considerations for diagnosis and an overview of the management of commonly reported symptoms through the experience of one of the 90 NHS England commissioned post Covid (Long Covid) assessment clinics, in addition to lived experiences of persons with Long Covid (PwLC). The next two articles in this series will look at the use of digital technology in Long Covid self-management and virtual group assessments. [ABSTRACT FROM AUTHOR]

Post‐exertional symptom exacerbation (PESE) is a characteristic symptom of post‐COVID syndrome (PCS). This prospective study investigated the effect of a 6‐week structured World Health Organization (WHO) Borg CR‐10 5‐phase pacing protocol on PESE episodes and quality of life in a cohort of individuals with long‐standing PCS (average duration of symptoms was 17 months). Participants received weekly telephone calls with a clinician to complete the Leeds PESE questionnaire (LPQ) and identify the appropriate phase of the pacing protocol. EQ‐5D 5L was completed at the intervention's beginning and end to measure overall health. Thirty‐one participants completed the 6‐week protocol, with a statistically and clinically significant reduction in the average number of PESE episodes (from 3.4 episodes in Week 1 to 1.1 in Week 6), with an average decrease of 16% (95% CI: 9%−24%; p < 0.001) each week, and reduction across all three exertional triggers (physical, cognitive, and emotional). Physical activity levels showed moderate improvements during the intervention period. Mean EQ‐5D 5L scores improved from 51.4 to 60.6 points (paired difference of 9.2 points, 95% CI: 3.2−15.2 points; p = 0.004). A structured pacing protocol significantly reduces PESE episodes and improves overall health in PCS. [ABSTRACT FROM AUTHOR]