The highly anticipated and much-needed long COVID treatment guidelines from the CDC have finally been released. The guidelines are intended to address several issues faced by healthcare providers when attempting to treat long COVID patients. The CDC solicited input from physician groups and patient advocacy organizations while developing the guidelines. 

A few of the problems medical staff face include:

• There hasn’t been an agreed-upon definition of what constitutes long COVID
• Current lab testing options don’t definitively diagnose it
• Patients are presenting with a broad range of symptoms that lack immediately apparent connection to a prior SARS-CoV-2 viral infection

The guidance attempts to provide an approach and set of protocols from which healthcare professionals across the board can move forward with diagnosis and treatment.

Five Key Takeaways

The CDC’s webpage concerning the new guidelines highlights these five key points:

• “Post-COVID Conditions” (also known as ‘long COVID’) is an umbrella term for a wide variety of physical and mental health symptoms experienced by some patients who have recovered from acute COVID-19 sickness. These symptoms may either linger for more than 4 weeks past the initial infection, or develop post-recovery. They may also occur in people who were infected but asymptomatic or who had only mild symptoms at onset.
• Many long COVID symptoms can be managed by your primary care provider, using a person-centered approach to optimize daily function and quality of life.
• Lab and imaging tests should not be used as the sole measure of a patient’s well-being. Patient-reported experience should be acknowledged and taken seriously. 
• Healthcare professionals and patients are encouraged to collaboratively set achievable goals that focus on individual symptoms such as headaches, dizziness, involuntary movements, etc. Treatment plans that also include mental wellbeing can also be helpful.
• Guidance for healthcare professionals will likely evolve over time as evidence unfolds.

Helpful Tips

“One of our goals with putting out guidance like this is to raise awareness about the problem,” said John Brooks, the CDC’s chief medical officer for COVID-19. Healthcare personnel in geographical areas where there were low rates of sickness may not have the same knowledge base as those in areas that have been dealing with large scale infection and disease burden.

Beyond basic awareness of long COVID, the guidelines offer these considerations:

• Patients have reported symptoms that affect multiple organ systems, so a broad perspective is necessary.
• Doctors should factor in a patient’s entire medical history, including a history of asthma, autoimmune disease, or other conditions that could exacerbate the effects of COVID-19. 
• Not having a positive antibody or COVID-19 test doesn’t rule out the possibility of long COVID.
• Though lab testing is not definitive for diagnosing long COVID, in some cases it may help determine whether or not symptoms could be caused by a different illness or condition. Lab testing is encouraged if symptoms last for more than 12 weeks. 
• Holistic clinical care is part of effective therapy for post-COVID conditions, and providers should use standardized, trauma-informed approaches to analyzing patients’ symptoms.

The diagnostic process alone can be frustrating, Brooks said, especially when lab and imaging tests come back negative despite uncomfortable and even debilitating symptoms. “That’s why we say listen, focus on the things that the person is experiencing, and really work on well-being,” he said. When necessary, providers can refer patients to specialists or connect them with social services.

Many Questions Remain

Many questions remain about how to define long COVID in a way that is accurate and supports providers’ diagnostic and treatment efforts. As Georges Benjamin, executive director of the American Public Health Association, pointed out, it’s rarely clear whether COVID has caused new conditions, or has perhaps activated something that was already present. We also don’t know whether or not racial and ethnic minority groups who have been more likely to become infected with the virus are also more likely to suffer lingering symptoms. 

Doctors aren’t the only ones who seek some direction. The guidelines advise patients to pace themselves during their recovery so as not to overtax their systems, and to be observant. Detailed patient input, especially concerning such symptoms as breathing issues and post-exertional malaise, can help doctors propose appropriate diagnostic tests. 

The Need for More Research

The CDC is working in close partnership with the National Institutes of Health (NIH) to move research and answers forward as quickly and productively as possible. NIH Director Francis Collins has just announced the initial round of research grant recipients for the more than $1 billion provided by Congress to study long-term effects of the SARS-CoV-2 coronavirus. 

“Building the research support infrastructure is the first step,” Collins said, “before we can launch research studies including new randomized, placebo-controlled clinical trials, which we expect to make in the weeks and months ahead.”

Aaron Glatt, the chair of the department of medicine at Mount Sinai South Nassau, said there aren’t simple answers about how to treat the different symptoms, and he expects that an eventual treatment for long COVID will have multiple factors. “This isn’t something that’s going to be solvable, at least I don’t think, by taking a pill,” he said. “We need to learn a lot more about this.” 

*McIntire, Mary Ellen. (2021, June 15). CDC Issues Guidance for Treating ‘Long COVID’ Patients. Roll Call. https://www.rollcall.com/2021/06/15/cdc-issues-guidance-for-treating-long-covid-patients/

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions. 

This content is only meant to serve as information and should not, in any way, be taken as medical advice. Patients should discuss all issues regarding vaccines, treatment, symptom management, and other condition-related factors with their physician or a qualified healthcare provider before making a decision regarding their care.