Byline: Dr. Margaret Hessen, MD, Infectious disease physician and Editor-in-Chief of Elsevier Point-of-Care

We are now two years into the SARS-CoV-2 pandemic. Early on we were constantly caught off-guard by the steady emergence of new and unpredictable COVID manifestations. Eventually we got better at managing the disease, through development or repurposing of antiviral drugs, monoclonal antibodies, immune modulators and a better understanding of effective support measures.

We’ve learned a lot. One area of continued frustration lingering questions is the prolonged and often disabling condition known colloquially as “long COVID.” “Long haulers,” as they have come to call themselves, report suffering from shortness of breath, fatigue, loss of smell, difficulty with concentration and memory, and chest pain for weeks to months after their initial illness.

Dr. Margaret Hessen is an infectious disease physician and Editor-in-Chief of Elsevier’s Point-of-Care team.

What do we know so far about the long-term effects of COVID-19?

Visit our Physical Rehabilitation toolkit for resources to support you in managing your patient’s recovery, whether at home or in a healthcare facility.

Lastly, vaccines have been found to be very effective in preventing people from becoming sick or dying from COVID. Check out our Vaccine Q&A video series to get answers to your vaccine questions.

Annotated Bibliography:

American Academy of Physical Medicine and Rehabilitation. COVID-19 Rehabilitation. 2022. Accessed 10 February 2022.

Antonelli M et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID symptom study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022;22(1):43-55. Accessed 10 February 2022.

CDC. Post-COVID Conditions: Interim Guidance. Key Points: Evaluating and caring for patients with post-COVID conditions. Updated 14 June 2021. Accessed 10 February 2022.

• Provides comprehensive information about background, clinical presentation, guidance on diagnosis and management

Greenhalgh et al. Management of post-acute COVID-19 in primary care. BMJ 2020; 370 doi: Published 11 August 2020. Accessed 10 February 2022.

• Includes descriptive content and guidance on workup and management, with a focus on cardiopulmonary symptoms

Nalbandian A et al. Post-acute COVID-19 syndrome. Nature Medicine. 2021; 27:601-615. Published 22 March 2021.

• Comprehensive review of post-COVID syndrome, including a comprehensive list of published studies to date (April 2021) and a system-by-system discussion of management, including available evidence and ongoing trials

NICE. COVID-19 Rapid Guideline: Managing the long-term effects of COVID-19. NICE Guideline [NG188]. Published 18 December 2020. Updated 11 November 2021.

• A joint guideline from NICE, SIGN and British Thoracic Society

Rajan et al. Policy Brief 39: In the wake of the pandemic. Preparing for long COVID. Health Systems and Policy Analysis: World Health Organization; 2021. Updated 22 March 2021.

• Provides comprehensive discussion and comparison of large clinical studies characterizing the condition, outlines regional responses and resources; extensive reference list

Siso-Almirall A et al. Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management Int J Environ Res Public Health. 2021 Apr; 18(8): 4350. Published online 2021 Apr 20. doi: 10.3390/ijerph18084350

• Proposed primary care clinical guidelines for diagnosis and disease management


Margaret Hessen

Margaret Trexler Hessen

MD, FACP, FSHEA, Director, Point of Care