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Clinical Pearls: Post-COVID-19 Conditions

Assessment and Testing

May or may not be indicated in post-COVID patients. Will help clarify or exclude other conditions. Includes complete blood count, ferritin, electrolytes, troponin, liver panel, renal function, C reactive protein, creatinine kinase, D-dimer, BNP, chest x-ray, urinalysis and EKG.

Risk Factors for the Development of Long-COVID

Read a worldwide analysis of patients with post-COVID conditions, including data on preexisting health conditions, location and demographics. https://patientresearchcovid19...

Management of Post-COVID Conditions

Stress Self-Management

Long haulers need to be encouraged to do all they can to support their own general health. Stop smoking; use a pulse oximeter daily; diet, rest and sleep; limit alcohol and caffeine; pace and gradually increase activity and exercise.


  • Fatigue is the most common symptom related to post-COVID with the male gender. Those who have comorbidities of hypertension and diabetes are at the greatest risk. Need to rule out other disorders and conditions that could be a cause.
  • Explore rehabilitation outcomes to improve post-COVID fatigue, breathlessness and cognition.

Cardiac Issues

  • Myocarditis — Long-haul symptoms are related to the severity of myocarditis and residual cardiomyopathy. Evaluation, diagnosis and management algorithms are accessible at:
  • Current evidence does not support the routine utilization of advanced cardiac imaging, and this should be considered on a case-by-case basis.
  • Recommendations for competitive athletes with cardiovascular complications related to COVID-19 include abstinence from competitive sports or aerobic activity for three to six months until the resolution of myocardial inflammation by cardiac MRI or troponin normalization.


Standard therapies should be implemented for neurologic complications such as headaches, with imaging evaluation and referral to a specialist reserved for refractory headache.

Respiratory Issues

  • Treatment with corticosteroids may be beneficial in a subset of patients with post-COVID inflammatory lung disease, as suggested by a preliminary observation of significant symptomatic and radiological improvement.
  • Rehabilitation outcomes to improve post-COVID fatigue, breathlessness and cognition.

“Brain Fog” and Cognitive Impairment

Rehabilitation outcomes to improve post-COVID fatigue, breathlessness and cognition.

Mood Changes

Standard screening tools should be used to identify patients with anxiety, depression, sleep disturbances, PTSD, dysautonomia and fatigue.


Malnutrition has been noted in 26%-45% of patients with COVID-19. Protocols to provide nutritional support for patients (many of whom suffered from respiratory distress, nausea, diarrhea and anorexia, with a resultant reduction in food intake) continue to be refined.

Health Inequities

Long COVID is significantly impacted by social determinants of health with the primary care provider in a perfect position to provide care and coordinate care for this vulnerable population of long haulers.

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