Management of Post-COVID-19 Conditions
Clinical Practice Brief
Introduction
- This practice brief provides guidance for clinicians regarding multiple post-COVID conditions for workup and management, as well as references to the full guidance.
- Coronavirus disease 2019 (COVID-19) is a disease caused by a novel virus, SARS-CoV-2. This virus was first identified in December 2019 in Wuhan, China. The virus is highly contagious, being spread by respiratory droplets, and it quickly became a worldwide pandemic. The acute illness phase can vary from mild to severe, including causing death.
- There are individuals who have contracted COVID-19 (could have been mild to severe disease burden) and develop post-COVID conditions, which can be referred to as long COVID, long-haul COVID, post-acute COVID-19, long-term effects of COVID or chronic COVID. To be considered long COVID, these conditions need to be present greater than four weeks.
- Experts from around the world are still trying to learn more about post-COVID conditions, including who gets it and treatment options. There is ever-changing information among health care experts. Because there is ever-changing information on this topic the most current source is the Centers for Disease Control and Prevention (CDC).
- Individuals with post-COVID are covered under the Americans with Disabilities Act as of July 2021.
Guideline Summary
General Clinical Considerations: Individuals with post-COVID can have lingering symptoms and post-acute infection for weeks to months. Long-haulers can have a single symptom or multiple symptoms that affect various body systems. Women are seemingly more affected than men. Below are links to various post-COVID conditions and related treatment or care options.
Patient History and Physical Exam: The history of present illness (HPI) should include the COVID disease course, severity and treatments received, as well as the timeline of acute and post-symptomology. HPI should include past medical conditions that could impact acute and post-COVID conditions. A complete physical needs to be conducted due to the multiple organ systems involved in post-COVID, which should include pulse oximetry and standard vitals and may include orthostatic vital signs, based on symptoms.
Assessment and Testing: At this time, there is no test that distinguishes post-COVID from other conditions. The history, physical and clinical findings should guide laboratory testing. View Clinical Pearls.
Management of Post-Covid Conditions: The goal of medical management is to optimize quality of life and functioning. Shared decision-making and transparency are needed. Develop a comprehensive plan that includes specialists as needed, based on the patient’s preexisting conditions (mental/psychiatric), presenting symptoms and personal and social situations. Follow-up visits should be every two to three months, but the frequency may be adjusted based on the patient’s condition and disease progression. View Clinical Pearls.
Future Directions and Resources: Ongoing research is causing rapid changes with the knowledge of post-COVID syndromes. Continually check for updates on evolving information on post-COVID conditions.
Considerations
The ICD-10 code is U09.9 Post COVID-19 condition, unspecified.
Reference
Centers for Disease and Control and Prevention. Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance for Healthcare Providers. Updated June 14, 2021 https://www.cdc.gov/coronaviru....