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Последний просмотренный: 28 Mar 2026
Last updated: 09 Oct 2025

Резюме

Определение

Анамнез и осмотр

Другие диагностические факторы

  • fatigue
  • myalgia or arthralgia
  • sore throat
  • headache
  • rhinorrhoea or nasal congestion
  • sneezing
  • expectoration
  • chest pain/tightness
  • malaise
  • dizziness
  • confusion or delirium
  • gastrointestinal symptoms
  • cutaneous symptoms
  • ocular symptoms
  • signs of pneumonia or acute respiratory distress
  • haemoptysis
  • audio-vestibular symptoms
  • oral mucosal lesions

Факторы риска

  • contact with probable or confirmed case
  • residence/work in location with high risk of transmission
  • older age
  • male sex
  • ethnicity
  • residence in a long-term care facility
  • presence of comorbidities
  • obesity
  • cardiovascular disease
  • diabetes
  • chronic respiratory disease
  • chronic kidney disease
  • chronic liver disease
  • pregnancy
  • smoking
  • malignancy
  • cerebrovascular disease
  • mental health disorders
  • solid organ or blood stem cell transplant
  • disabilities
  • dementia
  • Parkinson's disease
  • immunosuppression
  • HIV infection
  • physical inactivity
  • haemoglobin disorders
  • haemophilia
  • hypertension
  • epilepsy
  • substance use disorders
  • children with certain underlying conditions
  • vitamin D deficiency
  • proton-pump inhibitor use
  • corticosteroid use
  • autoimmune disease
  • inflammatory arthritis
  • inflammatory bowel disease
  • connective tissue disease
  • vasculitis
  • multiple sclerosis
  • thyroid disease
  • gout
  • dyslipidaemia
  • surgery
  • blood groups A and B
  • gut dysbiosis
  • zinc deficiency

Диагностические исследования

Исследования, которые показаны в первую очередь

  • real-time reverse transcription polymerase chain reaction (RT-PCR)
  • rapid antigen test
  • pulse oximetry
  • ABG
  • FBC
  • comprehensive metabolic panel
  • blood glucose level
  • coagulation screen
  • cardiac biomarkers
  • serum C-reactive protein
  • serum erythrocyte sedimentation rate
  • serum lactate dehydrogenase
  • serum procalcitonin
  • serum ferritin level
  • blood and sputum cultures
  • chest x-ray

Алгоритм лечения

Contributors

Expert advisers

Jennifer M. Hendrick, MD

Assistant Professor of Medicine

University of Virginia Health System

Division of Infectious Diseases and International Health

Charlottesville

VA

Divulgaciones

JMH declares she has filed a patent application for dupilumab for treatment of COVID-19. However there is no current commercial activity related to this.

Tom E. Fletcher, MBE, PhD, MBChB, MRCP, DTM&H

Senior Clinical Lecturer and Defence Consultant in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

Divulgaciones

TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General, the NHS, and Liverpool School of Tropical Medicine. TEF is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with the UK Health Security Agency (UKHSA; formerly Public Health England), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. He has received research grants from the Wellcome Trust, Medical Research Council, and the UK Public Health Rapid Support Team (UK-PHRST). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or UKHSA.

Robert Fowler, MDCM, MS (Epi), FRCP(C)

H. Barrie Fairley Professor of Critical Care

University Health Network and Interdepartmental Division of Critical Care Medicine

Director

Clinical Epidemiology and Health Care Research

Institute of Health Policy, Management and Evaluation

Dalla Lana School of Public Health

University of Toronto

Chief

Tory Trauma Program

Sunnybrook Hospital

Toronto

Canada

Disclosures

RF declares that he has no competing interests.

Acknowledgements

Dr Jennifer M. Hendrick​, Dr Tom E. Fletcher, and Dr Robert Fowler would like to gratefully acknowledge Dr Nicholas J. Beeching, previous contributor to this topic.

Disclosures

NJB is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with the UK Health Security Agency (UKHSA; formerly Public Health England), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or UKHSA.

Peer reviewers

William A. Petri, Jr., MD, PhD

Professor

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Xin Zhang, MD, PhD

Attending Physician

The Fifth Medical Center of PLA General Hospital

Clinical Division and Research Center of Infectious Disease

Beijing

China

Disclosures

XZ declares that he has no competing interests.

Ran Nir-Paz, MD

Associate Professor in Medicine

Department of Clinical Microbiology and Infectious Diseases

Hadassah Hebrew University Medical Center

Jerusalem

Israel

Disclosures

RNP has received research grants from US-Israel Binational Science Foundation, Hebrew University, Rosetrees Trust, and SpeeDx. He is chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC). RNP is a consultant for and has stocks in eDAS Healthcare. He is also chairperson of the Israeli Society for Infectious Diseases guidelines committee.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Expert advisers: comorbidities

Martyn Patel, BMBcH, FRCP, MA

Consultant, Older People's Medicine

Norfolk and Norwich University Hospitals

NHS Foundation Trust

Clinical Associate Professor in Translational and Clinical Medicine

Norwich Medical School

University of East Anglia

Norwich

UK

Disclosures

MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP participated in a podcast on the evolving nature and importance of comorbidities for BMJ Best Practice in October 2024.

Paul Cockwell, PhD, FRCP

Consultant Nephrologist

Queen Elizabeth Hospital Birmingham

Professor of Nephrology (honorary)

University of Birmingham

Birmingham

UK

Disclosures

PC is medical director for long-term conditions and prevention for NHS Birmingham and Solihull, with responsibilities that include commissioning and transformation of clinical care including areas relevant to the information on chronic kidney disease in the BMJ Best Practice Comorbidity Manager. PC has a non-remunerated research partnership with Boehringer Ingelheim into the epidemiology of chronic kidney disease. PC has received honoraria from Astra Zeneca for leading educational meetings for chronic kidney disease and long-term conditions. PC is author of the BMJ Learning module on chronic kidney disease. PC is immediate past-president (2021-2024) of the UK Kidney Association (UKKA), which is the UK professional organisation that supports healthcare professionals involved in care for, and research, innovation and education in, kidney disease. UKKA has a broad remit with relationships with multiple partners and includes responsibility for UK Kidney Week, the major educational meeting for UK kidney professionals.

Rajiv Sankaranarayanan, MBBS, FRCP (Lon), FESC, FHFA, PhD

Consultant Cardiologist and Heart Failure Lead (Cheshire and Merseyside Cardiac Network)

Liverpool University Hospitals NHS Foundation Trust

Honorary Clinical Associate Professor

Liverpool Centre for Cardiovascular Science

University of Liverpool

Liverpool

UK

Disclosures

RS has research grants from the British Heart Foundation, the NIHR, NHSX (Transformation Agency), AstraZeneca, Biotronik, and the University of Liverpool. RS has received speaker fees/honoraria and travel reimbursement for conferences from AstraZeneca, Novartis, Vifor, Medtronic, Biotronik, Pfizer, Daaichi Sankyo, Roche, and Boehringer. RS has been appointed to: NHS England GIRFT Clinical Lead; NHS England HF Clinical Lead for Cheshire and Merseyside ICB; NHS England PIFU Pathway Committee for Heart Failure (2021); British Cardiovascular Society Vice President Digital, Communications and Media Committee; British Society for Heart Failure Education Committee Chair; Clinical Advisory Board of UK’s patient-led charity Pumping Marvellous (2020); and NHS England HF Expert Advisory Group, European Society of Cardiology Heart Failure Digital Committee.

Rachael Evans, MBChB, FRCP (UK), PhD

Professor (Clinical)

University Hospitals of Leicester NHS Trust

Honorary Consultant Respiratory Physician

Glenfield Hospital

Leicester

UK

Declarações

RAE has given a lecture for a non-promotional industry-led session on long COVID by Moderna in 2023 and provided consultancy for a long COVID project for Astra Zeneca over the past 36 months totalling <£3000. RAE is the Chief Investigator for a long COVID study funded by Genentec Roche by a grant awarded to the University of Leicester.

Gerry Rayman, MD, FRCP, MBE

Consultant Physician

The Diabetes and Endocrine Centre and the Diabetes Research Unit

Ipswich Hospitals NHS Trust

Ipswich

UK

Раскрытие информации

GR received funding from Abbott in 2025 to attend the European Association for the Study of Diabetes conference. GR declares he received speaker fees from Abbott and consultancy fees from Eli Lily. GR undertakes several research projects on behalf of East Suffolk and North Essex NHS Foundation Trust for pharmaceutical companies which are on the NIHR portfolio (he does not receive payment himself for these).

Sotiris Posporelis, MD, MRCPsych

Consultant Liaison Neuropsychiatrist

King’s College Hospital

South London and Maudsley NHS Foundation Trust

Honorary Senior Clinical Lecturer

Institute of Psychiatry, Psychology & Neuroscience

King’s College London

London

UK

Disclosures

SP declares that he has no competing interests.

Asangaedem Akpan, MPH, FRCP

Consultant Geriatrician

Bunbury Regional Hospital

Western Australia Country Health Service

Bunbury

Western Australia

Visiting Professor

University of Cumbria

Carlisle

Honorary Clinical Associate Professor

University of Liverpool

Liverpool

UK

Disclosures

AA has a limited company that is seeking consultancy work offering reviews of healthcare services, facilitation of workshops, advice/review of publications.

Sanjay Agrawal, MBChB, FRCP

Consultant in Respiratory and Intensive Care Medicine

University Hospitals of Leicester NHS Trust

Leicester

National Speciality Advisor on Tobacco

NHS England and the Special Advisor for Tobacco for the Royal College of Physicians

London

UK

Disclosures

SA is a board member of Action for Smoking for Health (ASH), a healthcare charity related to tobacco control advocacy. SA is the National Specialty Advisor on Tobacco for NHS England and the Special Advisor for Tobacco for the Royal College of Physicians. SA undertakes research on the field of tobacco control but is not chief investigator for any studies at the time of making this declaration nor has he received any money or grants from pharmaceutical companies.

Adrian Parry-Jones, BSc(Hons), MBChB(Hons), MRCP, PhD, FESO

Professor of Vascular Neurology

Division of Cardiovascular Sciences

School of Medical Sciences, Faculty of Biology, Medicine & Health

University of Manchester

Honorary Consultant Neurologist

Manchester Centre for Clinical Neurosciences

Salford Care Organisation

Northern Care Alliance NHS Foundation Trust

Greater Manchester

UK

Disclosures

APJ's current and previous (< 36 months) research funding has come from the Natalie Kate Moss Trust, The Stroke Association, Medical Research Council, Brain Research UK, British Heart Foundation, and the Engineering and Physical Sciences Research Council. APJ is currently conducting an MRC-funded, investigator-initiated research study which includes testing of the LVOne lateral flow test supplied as an in-kind contribution by UpFront Diagnostics. APJ has previously been reimbursed for Scientific Advisory Board membership by Alveron Pharma Inc, but this position ended on 23 October 2025. APJ has previously been reimbursed by AstraZeneca for advisory board meetings and educational events, with the last engagement being on 2 August 2024. No further interaction with AstraZeneca is anticipated.

Acknowledgement: Martin Cowie

BMJ Best Practice would like to gratefully acknowledge Professor Martin Cowie for his previous role as expert adviser for the cardiovascular disease information in the Comorbidities Manager.

Martin Cowie MD, MSc, FRCP, FRCP (Ed), FESC, FHFA, FACC

Professor of Cardiology

Imperial College London (Royal Brompton Hospital)

London

UK

Disclosures

MC is chair of the European Society of Cardiology Digital Health Committee and a trustee of the Atrial Fibrillation Society. He has previously been a non-executive director of the National Institute for Health and Care Excellence. MC provides consultancy advice to AstraZeneca, Servier, Abbott, Medtronic, Boston Scientific, and Genomics PLC. MC declares that none of these interests is directly related to topics advised on for this project.

Acknowledgement: Andrew Lewington

BMJ Best Practice would like to gratefully acknowledge Dr Andrew Lewington for his previous role as expert adviser for the chronic kidney disease information in the Comorbidities Manager.

Andrew Lewington, BSc (Hons), MBBS, MEd, MD, FRCP

Consultant Renal Physician

Honorary Associate Professor

Nephrology Department

Leeds Teaching Hospitals NHS Trust

Head of MBChB

School of Medicine

University of Leeds

Leeds

UK

Disclosures

AL has been the principal applicant/co-applicant for a number of grants including: Engineering and Physical Sciences Research Council Research - multiplexed AKI biomarker detection with a single molecule biosensor; Leeds Cares - a novel, non-invasive diagnostic approach to assess kidney transplant health through the targeted measurement of biomarkers of kidney injury and immune response in kidney transplant recipients at the Leeds Teaching Hospitals NHS Trust; Kidney Research Yorkshire - use of enhanced technology to characterise haemodialysis treatment for acute kidney injury (AKI); Bringing It Home - validation of a micro-sampling technique for measuring tacrolimus and creatinine remotely, and to fund a research nurse; British Renal Society - renal function assessment with point of care creatinine in diverse populations (RAPID), and several NIHR grants including on a) Improving the quality of post-discharge care following AKI b) An investigation into the use of remote blood sample collection to reduce health inequalities in patients with mental health disorders c) A comparison of remote blood collection devices: a human factor use study d) Defining the characteristics for a novel automatic device to monitor urine output in catheterised patients e) Leeds Medtech and In-vitro Diagnostic Cooperative Grant Extension f) Surgical MedTech Co-operative for the 2019/20 proof-of-principle funding stream g) A pilot investigation into the use of beta-trace protein for residual renal function estimation in haemodialysis h) Application of functional MRI to improve assessment of chronic kidney disease (AFiRM study) i) SuperResPath-Renal: Quantitative super-resolution technology for a fast, decentralised clinical diagnosis of renal pathologies. AL is the co-author of several manuscripts including on extracorporeal treatments, AKI, kidney function testing prior to contrast-enhanced CT, plasma exchange and glucocorticoids in severe ANCA-associated vasculitis, COVID-19 rapid diagnostics, multimodal image-guided ablation on management of renal cancer in Von-Hippel-Lindau syndrome, and a summary of NICE guidance on CKD. AL is the author of several book chapters on nephrology and AKI. AL has received expenses for accommodation and travel for conferences at which he has given lectures, other than those delivered virtually. AL was a member of the AKI Scientific Program Committee for the ISN World Congress of Nephrology 2020-2021 and Chair of this same committee in 2021-2022.

Acknowledgement: Matthew Jones

BMJ Best Practice would like to gratefully acknowledge Dr Matthew Jones for his advice on a section of the stroke comorbidity content.

Matthew Jones, MD, FRCP

Consultant Neurologist

Manchester Centre for Clinical Neurosciences

Northern Care Alliance

Honorary Senior Lecturer

University of Manchester

Manchester

UK

Disclosures

MJ is the chair of the Association of British Neurologists Education Committee (unpaid position). MJ is a faculty member of an MRCP revision course. MJ has received honoraria from Eisai for educational talks.

Peer reviewers: comorbidities

Martyn Patel, BMBcH, FRCP, MA

Consultant, Older People's Medicine

Norfolk and Norwich University Hospitals

NHS Foundation Trust

Norwich

UK

Disclosures

MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP participated in a podcast on the evolving nature and importance of comorbidities for BMJ Best Practice in October 2024. MP is submitting an application to the NIHR Research for Patient Benefit (RfPB) Grant Call on physical frailty, an Integrated Care Board (ICB) priority.

Asangaedem Akpan, MPH, FRCP

Consultant Geriatrician

Bunbury Regional Hospital

Western Australia Country Health Service

Bunbury

Western Australia

Visiting Professor

University of Cumbria

Carlisle

Honorary Clinical Associate Professor

University of Liverpool

Liverpool

UK

Disclosures

AA has a limited company that is seeking consultancy work offering reviews of healthcare services, facilitation of workshops, advice/review of publications.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Bhimraj A, Morgan RL, Hirsch Shumaker A, et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19. May 2025 [internet publication].Full text

National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing COVID-19. May 2025 [internet publication].Full text

World Health Organization. Therapeutics and COVID-19: living guideline, August 2025. Sep 2025 [internet publication].Full text

World Health Organization. Clinical management of COVID-19: living guideline, June 2025. Jul 2025 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available here.

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