From the Guidelines
The management of long COVID should prioritize a comprehensive, individualized approach focusing on symptom relief and functional improvement, with a multidisciplinary care team addressing physical, psychological, and psychiatric aspects of rehabilitation. This approach is supported by the most recent and highest quality study, which emphasizes the importance of considering routine blood tests, chest imaging, and pulmonary function tests for patients with persistent respiratory symptoms at 3 months 1.
Key Components of Management
- A thorough assessment to identify specific symptoms, followed by targeted interventions
- For fatigue, a gradual return to activity through paced exercise programs is recommended, avoiding overexertion which can worsen symptoms
- Breathing difficulties may be addressed with breathing exercises and pulmonary rehabilitation
- For cognitive issues ("brain fog"), cognitive rehabilitation exercises and memory aids can be helpful
- Pain management often includes acetaminophen or NSAIDs like ibuprofen (400-600mg every 6-8 hours) for mild to moderate pain
- Sleep disturbances may be addressed through sleep hygiene practices and occasionally short-term use of medications like melatonin (1-5mg before bedtime)
- Mental health support is crucial, with cognitive behavioral therapy being particularly effective for anxiety and depression
- Nutritional support should focus on a balanced diet rich in anti-inflammatory foods
Importance of Multidisciplinary Care
The management of long COVID requires coordination between healthcare providers, as it affects multiple body systems 1. A multidisciplinary rehabilitation team should work with patients to make a plan for their rehabilitation, addressing physical, psychological, and psychiatric aspects of rehabilitation. Symptom diaries and symptom tracking apps can be helpful for self-monitoring, and patients should be advised on how to self-manage their symptoms, including setting realistic goals and seeking support when needed.
Ongoing Support and Rehabilitation
Recovery timelines vary significantly between individuals, with some symptoms resolving within months while others may persist longer, requiring ongoing management and adjustment of treatment strategies. Patients should be encouraged to contact their healthcare provider if they are worried about their symptoms or need support with self-management. Online support groups, social prescribing, and apps can provide additional sources of advice and support.
From the Research
Management of Long COVID
The management of long COVID, also known as post-acute sequelae of COVID-19 (PASC), involves a multidisciplinary approach to address the persistent symptoms that follow SARS-Cov-2 infection 2, 3, 4. The symptoms of long COVID can include fatigue, dyspnea, cognitive impairment, and decreased quality of life, and can vary in severity 2, 4.
Treatment Strategies
Treatment strategies for long COVID are symptom-focused and encompass multidisciplinary care, rehabilitation, and tailored exercise programs 2, 3, 4. Pulmonary rehabilitation has been shown to be an effective and critical component of long COVID management, particularly for patients with respiratory symptoms such as dyspnea 2, 5.
Rehabilitation Programs
Rehabilitation programs for long COVID typically combine exercise, breathing techniques, education, and psychological support to improve symptoms, quality of life, and overall recovery 2, 3, 5. These programs can be conducted in-person or remotely, using innovative technologies such as telemedicine, wearable devices, and telerehabilitation 2, 3.
Exercise-Based Therapy
Exercise-based therapy is an essential part of long COVID management and can be conducted with different modules, including telerehabilitation 3, 6. However, post-exertional symptom exacerbation and orthostatic hypotension should be carefully monitored during exercise 3. A symptom-titrated exercise program has been shown to be effective in reducing fatigue and improving quality of life in people with post-COVID condition 6.
Key Components of Management
The key components of long COVID management include: