What to know
- Long COVID is an infection-associated chronic condition that affects one or more organ systems.
- Primary care providers can manage Long COVID using patient-centered approaches.
- Objective laboratory or imaging findings should not be used as the only measure or assessment of a patient's well-being.
- Healthcare providers should set achievable patient care goals through shared decision-making and approach treatment by focusing on specific symptoms or conditions.
- Healthcare providers can help patients with Long COVID by validating their symptoms and connecting them to additional care, services, and supports, as appropriate.
- Providers should promote COVID-19 vaccines as a means of preventing Long COVID.
Diagnosis
Clinicians may clinically evaluate and diagnose Long COVID based on patient history and findings from a physical examination, while others might require directed diagnostic testing. Currently, no laboratory test can be used to definitively diagnose Long COVID or to distinguish Long COVID from conditions with different etiologies.
Presentation
Different onset patterns for Long COVID have been identified, including symptoms and conditions that can:
- Emerge, evolve, persist, resolve, and reemerge over time following initial acute COVID-19 illness.
- Develop following asymptomatic disease or a period of acute symptom relief or remission.
- Worsen pre-existing symptoms or conditions.
Documentation
Documenting SARS-CoV-2 infection and Long COVID, also referred to as Post-COVID Conditions, is critical for accurate public health surveillance and may help patients receive needed care.
ICD code to identify Post-COVID Conditions
Post-COVID Condition was incorporated into the International Classification of Diseases, ICD-10-CM as of October 1, 2021. U09.9 Post COVID-19 Condition, unspecified– to establish a link with COVID-19; not to be used in cases that still are presenting with acute COVID-19. The code should be used for patients with a history of probable or confirmed SARS-CoV-2 infection and who are identified with a Post-COVID Condition.
Additional assign codes for specific conditions and symptoms can be found at 2022 ICD-10-CM Guidelines.
Treatment and symptom management
For most patients, the goal of medical management of Long COVID is to optimize function and quality of life through established symptom management approaches, which may include:
- Focusing on the most bothersome symptoms identified by the patient.
- Creating a comprehensive rehabilitation plan.
- Optimizing management of underlying medical conditions.
- Creating patient diaries and calendars to document changes in health conditions and symptom severity.
Patients with Long COVID may experience some of the symptoms that occur in other disorders. These patients may benefit from symptom management approaches used to manage symptoms of:
- Fibromyalgia
- Post-treatment Lyme disease syndrome
- Dysautonomia
- Mast cell activation syndrome
- Post-exertional malaise (PEM)
Treatment of Long COVID should be tailored to a patient's specific symptoms or conditions, including FDA-approved or over-the-counter medications. Holistic support for the patient throughout their illness can also be beneficial. Healthcare providers play a significant role in supporting their patients and can further help patients with Long COVID by:
- Validating their symptoms
- Recognizing and validating the impact of illness on quality of life.
- Completing a full clinical evaluation based on signs and symptoms reported by the patient
- Connecting them to additional care, services and supports, as appropriate.
Resources
Disclaimer
Clinical guidance
Diagnosis and management
Similar Chronic Conditions
Adolescents and children with Long COVID
Patient support