Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post‐acute sequelae of <scp>SARS‐CoV</scp>‐2 infection (<scp>PASC</scp>)

Cheng, Abby L.; Anderson, Jordan; Didehbani, Nyaz; Fine, Jeffrey S.; Fleming, Talya K.; Karnik, Rasika; Longo, Michele; Ng, Rowena; Re'em, Yochai; Sampsel, Sarah; Shulman, Julieanne; Silver, Julie K.; Twaite, Jamie; Verduzco‐Gutierrez, Monica; Kurylo, Monica

doi:10.1002/pmrj.13085

Cited by 6 publications

(2 citation statements)

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“…Referral to mental health professionals-psychologists, licensed mental health practitioners, or clinical social workers-is warranted for patients experiencing psychological distress 12 . Participation in mental health services should not insinuate a psychosomatic origin of symptoms; rather, it acknowledges that such symptoms may be features of the neuroinflammatory spectrum of PASC and that there are evidence-based therapies for these conditions 50,51 .…”

Section: : Energy Management and Prevention Of Post-exertional Malaisementioning

confidence: 99%

“…Despite the existence of dedicated Post-COVID-19 clinics, their limited accessibility means PCPs often shoulder a considerable portion of care responsibilities. The American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the Center for Disease Control (CDC) have issued treatment guidance largely based on expert opinion that is primarily symptom-focused, emphasizing the exclusion of alternative diagnoses and providing management for individual symptoms [12][13][14][15][16][17][18][19][20] . Although PASC may manifest in various phenotypes and encompass multiple distinct processes, PASC's diverse presentations often involve symptom clusters that suggest interconnected pathophysiological mechanisms 9,21 .…”

Section: Introductionmentioning

confidence: 99%

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A Practical Framework for Long COVID Treatment in Primary Care

Brode,

Melamed

2024

Preprint

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Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), is a complex, multisystem illness with a poorly understood pathophysiology, absence of specific diagnostic tests or criteria, or evidence-based treatments. With over 200 identified symptoms and approximately 10% of COVID-19 cases resulting in PASC, it is a challenge to provide comprehensive treatment at a scale commensurate with the illness burden. The diverse manifestations of PASC, encompassing numerous medical specialties, typically place primary care providers (PCPs) at the forefront of management, navigating an evolving landscape of research and lack of evidence-based guidelines. This paper presents a pragmatic, structured framework for PASC management in primary care, integrating current knowledge and best practices. The approach is individualized, addressing PASC's broad symptomatology through a four-step framework. The first step focuses on energy management strategies, emphasizing the prevention of post-exertional malaise, a cardinal feature of PASC. The second step, intentional rehabilitation, employs carefully titrated multidisciplinary modalities to address physical, cognitive, and emotional domains. The third step utilizes symptomatic management through both pharmacological and non-pharmacological interventions, targeting debilitating symptoms like fatigue, insomnia, and chronic pain. The fourth step outlines an approach to trialing experimental, targeted therapies that may impact PASC's underlying pathophysiology. These treatments, while experimental and lacking quality evidence in PASC, may be available off-label on an individual basis following a thorough risk-benefit discussion. This stepwise framework can equip PCPs to effectively address the most common and disabling symptoms of PASC, individualize care, and remain attuned to the evolving scientific understanding of the condition.

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Section: : Energy Management and Prevention Of Post-exertional Malaisementioning

confidence: 99%