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Long COVID

Supporting Family Physicians and Patients

Long COVID, sometimes also called long-haul COVID, chronic COVID, and post-acute sequelae of SARS-CoV-2 infection (PASC), is a complex and variable chronic condition that can persist long after the acute phase of COVID-19 infection. Symptoms range from mild to debilitating and often fluctuate over time. These symptoms can affect anyone who has had COVID-19, even if their initial infection was mild or did not cause symptoms. The best way to reduce the risk of developing long COVID is by getting vaccinated against COVID-19. Evidence shows that people who are fully vaccinated are less likely to experience severe COVID-19 illness, which in turn can decrease their likelihood of developing long COVID.

Family physicians are essential in providing care for patients experiencing long COVID, offering support, coordination, and access to resources that address this complex condition.

Long COVID Symptoms

Documentation of a positive COVID-19 test is not required to diagnose long COVID. Long COVID encompasses a variety of symptoms that may affect multiple organ systems, ranging in severity and duration. Symptoms often fluctuate over time and can significantly impact daily functioning. Common symptoms include:

Fatigue or post-exertional malaise (PEM)
Shortness of breath or difficulty breathing
Cognitive impairment or "brain fog"
Chest pain or heart palpitations

Joint and muscle pain
Sleep disturbances, headaches, and rashes
Impaired ability to perform daily activities

For a full list of potential symptoms and updates, refer to the CDC’s Long COVID resources.

Resources and Guidance

Long COVID Resource Repository

The Long COVID Repository is intended to serve as a reference for primary care clinicians who face uncertainty and lack of evidence-based information to recognize, diagnose, and treat Long COVID. The Repository has also been developed with the recognition that treating patients with Long COVID and other infection-associated chronic conditions and illnesses will almost certainly require providers to employ a skillset that goes beyond the norms of most day-to-day practices. The lack of established biomarkers and diagnostic tests places a premium on understanding a patient’s lived experience and engaging patients as partners in navigating their treatment journey. This Repository is intended to help foster that relationship and provide guideposts for that journey.

AAPM&R Long COVID Compendium report

This evidence-based resource aims to equip clinicians with an efficient, up-to-date information for evaluating and managing adults experiencing Long COVID symptoms. It provides a holistic framework for assessment and management, symptom-specific considerations, and updates on prevalence, health equity, disability considerations, pathophysiology, and emerging evidence regarding treatments under investigation.

^{The AAFP is bringing you this content in partnership with the Council of Medical Specialty Societies with support from the CDC and HHS. This content was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $25,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.}

Counsel of Medical Specialty Societies (CMSS) video series

These video series feature discussions with experts who will help bolster your care of patients with long COVID.

CMSS Interviews With ACP, AAP, AAFP

Long COVID Education, Engagement and Care Management

Free Online CME: Updates in Long-COVID Conditions

You play a critical role in identifying, assessing and managing patients with long-COVID conditions. The AAFP is here to help you by providing the tools and evidence-based strategies you need to improve patient outcomes.

Explore valuable clinical resources, including member-exclusive free CME, to gain essential knowledge and skills to address health disparities within your patient populations.

Clinical Guidance: Long COVID Point-of-Care Resource

This evidenced-based Point-Of-Care resource empowers family physicians to provide individualized care as they diagnosis, manage, educate, and coordinate care for their patients experiencing ongoing symptoms long after a COVID-19 infection.

Talking to Patients About Long COVID

This page teaches the SHARE approach (Seek, Help, Assess, Reach and Evaluate) to facilitate shared decision making with patients experiencing long COVID.

Clinical Care and Management

The CDC offers clinical guidance for evaluating and managing patients with long COVID. This guidance includes:

Testing and evaluation strategies
Symptom management approaches
Coordination of care across multidisciplinary teams

As understanding of long COVID evolves, this guidance will continue to be updated. Family physicians are encouraged to stay informed through professional development opportunities and evidence-based resources, such as these two FPM supplements:

Disability Classification

Under guidance from the U.S. Department of Health and Human Services (HHS), long COVID may qualify as a disability under the Americans with Disabilities Act (ADA). This designation ensures that patients experiencing significant limitations due to long COVID are eligible for workplace or school accommodations. For more information, visit HHS’s long COVID disability resources.