CDC Releases New Long COVID Guidelines

The Centers for Disease Control and Prevention (CDC) has released interim guidance for healthcare providers on how to treat patients with post-COVID conditions, commonly referred to as “long COVID.”

“Based on current information, many post-COVID conditions can be managed by primary care providers, with the incorporation of patient-centered approaches to optimize the quality of life and function in affected patients,” the guidance says.

The guidance also urges practitioners to be sensitive to their patient's needs, citing reports of post-COVID conditions being misdiagnosed or falsely attributed to psychiatric causes.

“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 guidelines suggest.

What Does the Guidance Recommend?

The guidance is long and broad, covering everything from physical examinations, testing, and treatment, to how to talk to patients about post-COVID conditions.

Here are some of the biggest takeaways.

There Is a List of Symptoms for Post-COVID Conditions

The CDC included a comprehensive list of all the symptoms that people with long COVID may experience:

• Shortness of breath
• Fatigue
• Poor endurance or getting easily tired
• Brain fog
• Cough
• Chest pain
• Headache
• Palpitations
• Joint pain
• Muscle pain
• Pins and needles
• Abdominal pain
• Diarrhea
• Insomnia and other sleep difficulties
• Fever
• Lightheadedness
• Impaired daily function and mobility
• Pain
• Rash
• Mood changes
• Loss of smell or altered sense of taste
• Menstrual cycle irregularities

Doctors Are Urged to Not Rely Solely on Lab Testing

The CDC specifically notes that there is no laboratory test that can effectively distinguish post-COVID conditions from other health issues.

They also warn providers against relying solely on lab tests to determine if something is physically wrong with a patient.

"Objective laboratory or imaging findings should not be used as the only measure or assessment of a patient’s well-being; lack of laboratory or imaging abnormalities does not invalidate the existence, severity, or importance of a patient’s symptoms or conditions," the CDC writes.

Providers Should Not Automatically Attribute Symptoms to Mental Health Issues

“Patient advocacy groups have raised concerns that some post-COVID conditions have been either misdiagnosed as or misattributed to psychiatric causes, particularly among persons who belong to marginalized or vulnerable groups,” the CDC states.

Instead, they encourage healthcare providers to be sensitive to this and complete a full clinical evaluation first.

Recommendations for Treatment

The CDC says that many post-COVID conditions can be improved through treatments that are already established, like using breathing exercises to improve shortness of breath.

“Creating a comprehensive rehabilitation plan may be helpful for some patients and might include physical and occupational therapy, speech and language therapy, vocational therapy, as well as neurologic rehabilitation for cognitive symptoms,” the CDC says.

Doctors Applaud the Guidance

“The guidance is a good step toward formalizing the diagnosis and treatment of post-COVID syndromes,” infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, tells Verywell. “They provide a basis for approaching a patient and thinking about how to direct the care of these individuals.”

Stanley H. Weiss, MD, professor at both the Rutgers New Jersey Medical School and Rutgers School of Public Health, agrees, calling the guidance “objective, well-written, and well-referenced.” The guidance is also “very helpful laying out what we know and what we don’t know,” he tells Verywell.

The guidance is “particularly helpful” to let providers know that patients with post-COVID conditions “will have a wide range of symptoms," Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York, tells Verywell. The guidance stresses that “really, any organ in the body can be affected with this," he adds.

At the same time, Russo says, it’s “crucially important” for providers to realize that a patient's symptoms could be unrelated to COVID-19. “We need to be open-minded and remember that medicine is still happening independent of COVID.”

But while the guidance can be helpful to remind doctors that they won’t necessarily get answers to their patients’ symptoms from tests, Kathryn Boling, MD, a primary care physician at Baltimore's Mercy Medical Center, tells Verywell that “there’s really nothing there” to tell those in the medical field how to treat patients.

“I bring my patients in right after they’re sick, get an [electrocardiogram] on them, listen to their lungs, and get a CT scan,” she says. “But I also believe them if they tell me something is happening, and I try to treat them the best way I know how.”

Adalja calls the guidance a “framework” for clinicians, adding, “there is still a lot to be learned about this condition.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.