Sly Saint
Senior Member (Voting Rights)
Nov. 22, 2022 – Diagnosing long COVID is something of an art for doctors who, without any formal criteria, say they know it when they see it. Treating the condition requires equal combinations of skill, experience, and intuition, and doctors waiting for guidelines have started cobbling together treatment plans designed to ease the worst symptoms.
Their work is urgent. In the U.S. alone, as many as 29 million people have long COVID, according to estimates from the American Academy of Physical Medicine and Rehabilitation.
“Patients with long COVID have on average at least 14 different symptoms involving nine or more different organ systems, so a holistic approach to treatment is essential,” says Janna Friedly, MD, executive director of the Post-COVID Rehabilitation and Recovery Clinic at the University of Washington in Seattle.
For acute COVID cases, the National Institutes of Health has treatment guidelines that are taking a lot of the guesswork out of managing patients’ complex mix of symptoms. This has made it easier for primary care providers to manage people with milder cases and for specialists to come up with effective treatment plans for those with severe illness. But no such guidelines exist for long COVID, and this is making it harder for many doctors – particularly in primary care – to determine the best treatment.
While there isn’t a single treatment that is effective for all long COVID symptoms – and nothing is approved by the FDA specifically for this syndrome – doctors do have tools, Friedly says.
“We always start with the basics – making sure we help patients get enough restorative sleep, optimizing their nutrition, ensuring proper hydration, reducing stress, breathing exercises, and restorative exercise – because all of these are critically important to helping people’s immune system stay as healthy as possible,” she says. “In addition, we help people manage the anxiety and depression that may be exacerbating their symptoms.”
Fatigue is an obvious target. Widely available screening tools, including assessments that have been used in cancer patients and people with chronic fatigue syndrome, can pinpoint how bad symptoms are in long COVID patients.
link for 'chronic fatigue syndrome' goes to the NICE guidelines.......unfortunately 2007 page...but at least now it says in a large banner on the page
"Guidance
This guideline has been updated and replaced by NICE guideline NG206. "
https://www.webmd.com/lung/news/20221122/docs-make-their-own-long-covid-protocols
the article goes on to say:
“Traditional exercise programs may be harmful to some patients with long COVID,” says Verduzco-Gutierrez. “Many cannot tolerate graded exercise [where exertion slowly ramps up], and it actually can make them worse.”
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