Preliminary Guidelines for the Clinical Evaluation and Management of Long COVID

Yoonjung Kim; Seong Eun Kim; Tark Kim; Ki Wook Yun; So Hee Lee; Eunjung Lee; Jun-Won Seo; Young Hee Jung; Yong Pil Chong

doi:10.3947/ic.2022.0141

Preliminary Guidelines for the Clinical Evaluation and Management of Long COVID

Infect Chemother. 2022 Sep;54(3):566-597. doi: 10.3947/ic.2022.0141.

Authors

Yoonjung Kim¹, Seong Eun Kim², Tark Kim³, Ki Wook Yun⁴, So Hee Lee⁵, Eunjung Lee⁶, Jun-Won Seo⁷, Young Hee Jung⁸, Yong Pil Chong⁹

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
² Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
³ Divison of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
⁴ Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
⁵ Department of Psychiatry, National Medical Center, Seoul, Korea.
⁶ Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
⁷ Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea.
⁸ Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
⁹ Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. drchong@amc.seoul.kr.

Abstract

Long-lasting coronavirus disease 2019 (COVID-19) symptoms beyond 12 weeks, the so-called 'long COVID' have been increasingly reported worldwide. Long COVID can be manifested in various forms, and there is an increasing demand for proper assessment and management. However, it is challenging when trying to determine the best-practice standards of care based on the current evidence because there is no internationally agreed clinical definition or clear treatment pathway. Therefore, the present guidelines have been drafted to provide advice on diagnosis and management based on the latest updated available evidence and the consensus of expert opinion. So far, no standard test and drug treatment can be strongly recommended for patients with long COVID because of a lack of evidence. The present guidelines provide advice based on 12 key questions, including appropriate interventions for long COVID that can be used in clinical practice. Continuous careful observation and studies related to long COVID are needed for the long-term impact of COVID-19 and proper management for long COVID to be determined.

Keywords: Long COVID; Management; Persistent symptoms; Post-COVID condition; SARS-CoV-2.

Publication types

Review