CDC releases guidance on long COVID

The Centers for Disease Control and Prevention released its much anticipated guidance for health care providers on treating patients with long COVID late Monday night, urging providers to be empathetic in their approach in response to patient concerns that symptoms are being either misdiagnosed or inaccurately assumed to be psychiatric-related.

“Sensitivity to and awareness of stigma, completing a full clinical evaluation, and maintaining an attitude of empathy and understanding can help address these concerns,” the guidance says.

The new guidance, which has been met with online praise from some long COVID advocates, uses the term “post-COVID conditions” as an “umbrella term for the wide range of physical and mental health consequences experienced by some patients that are present four or more weeks after SARS-CoV-2 infection, including by patients who had initial mild or asymptomatic acute infection.” It offers diagnosis considerations, treatment and management guidance, and public health recommendations, but adds that an understanding of the symptoms plaguing COVID long-haulers is still limited.

Dr. John Brooks, chief medical officer for the CDC’s COVID-19 response told U.S. News in May that the guidance was developed with a number of CDC and health care industry experts, with collaboration from the American College of Physicians, the American Academy of Family Medicine, the American Academy of Pediatrics and others. Additionally, organizations including long COVID patients and advocates – such as Survivors Corps, Body Politic and the Long COVID Alliance – were given input. Those three advocacy groups, along with Long COVID Kids, are referenced as additional resources in the guidance.

According to the CDC, post-COVID conditions can be treated by primary care providers with patient-centered approaches as well as by setting achievable goals that focus on specific symptoms, such as treating a patients’ rapid heart rate. It also recommends that providers create a comprehensive care management plan that takes into account a patients’ physical and mental health.

There is currently no definitive test to diagnose long COVID. The guidance suggests that polymerase chain reaction (PCR) or antibody tests may be useful in determining a diagnosis of post-COVID but notes they are not a requirement.

It says those tests “are not 100% sensitive” and that since testing capacity was limited early in the pandemic, some people who developed COVID-19 had no chance to confirm their infection.

The guidance suggests health care providers consider a basic panel of laboratory tests for patients with ongoing symptoms, including blood tests, liver function tests and thyroid function tests.

The guidance also urges providers to deploy resources to communities of color, which have been among those hit hardest by the pandemic. Brooks has said there is no data yet on how many people have long COVID or if it’s more likely in certain populations, but told members of Congress in April that it’s likely that marginalized groups are “disproportionately impacted by these conditions as they are more likely to acquire SARS-CoV-2 and less likely to be able to access health care services.”

The guidance suggests special consideration should be given to patients with disabilities, people experiencing homelessness and others who may struggle with accessing health care.

It recommends developing a long COVID diagnostic code, which a CDC official told U.S. News not only allows for billing purposes, but helps legitimize the condition. Additionally, it suggests that COVID-19 vaccines continue to be offered to patients with post-COVID symptoms. Some long-haulers have said getting a COVID-19 vaccine has relieved some symptoms, but it’s too soon to tell whether this is an effective treatment. US News