eCase - FAQ Module: COVID-19

Frequently Asked Questions on COVID-19 Epidemiology, Prevention, and Clinical Management

Released: June 01, 2022

Expiration: May 31, 2023

Arthur Kim, MD

Sharon R. Lewin, AO, FRACP, PhD, FAHMS

Renslow Sherer, MD

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Introduction Vaccines: Questions and Answers Antiviral Agents: Questions and Answers The Omicron Era: Questions and Answers Long COVID: Questions and Answers References

What is long COVID?

Short answer: New or ongoing symptoms ≥4 weeks post COVID-19 infection that last for ≥2 months and cannot be explained by another diagnosis.

Renslow Sherer, MD (March 24, 2022):
Long COVID, also known as postacute sequelae of COVID-19 infection, has multiple definitions but is generally known as new or persistent symptoms of COVID-19 infection ≥4 weeks after the initial infection.Typical symptoms include fatigue, cough, shortness of breath, exercise intolerance, and sleep disruption, but many others—affecting numerous body systems—may be present.^{CDC Post-COVID; Seeßle 2022}

What are the risk factors for long COVID?

Short Answer: Presence of certain comorbidities, autoantibodies, and amount of circulating SARS-CoV-2 virus at the time of COVID-19 infection may be risk factors for long COVID development.

Renslow Sherer, MD (March 24, 2022):
A recent study demonstrated that if present at the time of COVID-19 infection diagnosis, type 2 diabetes, Epstein-Barr virus viremia, autoantibodies to type I interferons, and amount of circulating SARS-CoV-2 viremia may increase a person’s risk for developing long COVID.^{Su 2022}

Are there any differences in long COVID based on the SARS-CoV-2 variant?

Short Answer: There may be differences, but we do not have enough information yet to know for certain.

Renslow Sherer, MD (March 24, 2022):
The omicron variant was first identified in the United States in December 2021. The omicron variant spreads more easily than delta and presents with symptoms similar to other variants.^{CDC Omicron} Because long COVID symptoms are defined as starting ≥4 weeks after being infected with SARS-CoV-2 and can last for weeks to months,^{CDC Post-COVID}not enough time has elapsed to understand how long COVID may be different with the omicron variant compared with prior variants.

What is the role of telehealth in the management of patients with long COVID in the primary care setting?

Short Answer: Telehealth can be an option for management of patients with long COVID, but the technology can be challenging for some patients and healthcare professionals.

Renslow Sherer, MD (March 24, 2022):
When available and accessible, telehealth is a way for patients to receive the care they need without having to leave their homes. Patients may be able to use remote monitoring devices (eg, home pulse oximetry) to collect data at home for the telehealth appointment. Telehealth should be viewed as a bridge between in-person appointments, as some long COVID symptoms may warrant an in-person assessment or laboratory monitoring.^{HHS Telehealth}

How does COVID-19 vaccination affect incidence of long COVID?

Short Answer: COVID-19 vaccination may be protective in reducing symptoms or incidence of long COVID.

Renslow Sherer, MD (March 24, 2022):
Data suggest that vaccinated individuals who develop a breakthrough COVID-19 infection are less likely to report symptoms of long COVID. There is also evidence that unvaccinated individuals who developed long COVID experience reduced symptoms when subsequently vaccinated.^{UK HSA Long COVID} However, the studies were observational, and the definition of long COVID is not universal, so differences observed may have been due to something other than vaccination status.

Is there anything to specifically treat long COVID?

Short Answer: Several currently available drugs and investigational agents are being studied for use in treating patients with long COVID.

Renslow Sherer, MD (March 24, 2022):
There are no proven treatment recommendations for patients with long COVID. Several investigational agents that target inflammation and immune response are being studied, as are currently available drugs that may have beneficial effects in treating long COVID symptoms.^{Schmidt 2021}

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