Without Guidelines, Docs Make Their Own Long COVID Protocols

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Treating the long COVID 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.

, which have been studied for managing fatigue in patients with other conditions like cancer, multiple sclerosis, traumatic brain injuries, and Parkinson’s disease. But there isn’t yet clear evidence from clinical trials about how well these options work for long COVID.borrow a page from treatments used for other conditions like stroke and dementia – but require changes to meet the needs of those with long COVID.

The lack of formal guidelines is especially a problem because there aren’t nearly enough specialists to manage the surge of patients who need treatment for issues like fatigue and brain fog. And without guidelines, primary care providers lack a reliable road map to guide referrals that many patients may need.

One barrier to developing guidelines for long COVID is the lack of research into the biological causes of fatigue and autonomic dysfunction – nervous system damage that can impact critical things like blood pressure, digestion, and body temperature – that affect so many long COVID patients, says Alba Miranda Azola, MD, an assistant professor and co-director of the Post-Acute COVID-19 Team at Johns Hopkins University School of Medicine in Baltimore.

The vast number of symptoms, surfacing in different ways for each patient, also make it hard to isolate specific ways to manage specific long COVID symptoms. Even when two patients have fatigue and brain fog, they may still need different treatments based on the complex mix of other symptoms they have.

 

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