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Long COVID Information for Providers

Long COVID is defined as an infection-associated chronic condition that occurs after a symptomatic or asymptomatic SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems. Anyone who has had a COVID-19 infection, regardless of severity, can develop Long COVID, including children.

Long COVID is a complex problem that requires multidisciplinary solutions. Long COVID care may need to be coordinated through primary care providers and multiple specialists who can help with specific aspects of a patient’s illness, such as cardiologists, neurologists, autoimmune specialists, and rehabilitation providers.

A key component of supporting patients with Long COVID is acknowledging and taking concerns seriously.

As of now there are no peer-reviewed screening tools for Long COVID. However, the Post-COVID-19 Functional Status (PCFS) scale was created to monitor functional limitations over time after COVID-19. 

For more information, see the latest Dear Colleague Letter on Long COVID (PDF, September 2024).


Treatment

Presently, there is no specific treatment recommended for people with Long COVID. Treatment and management plans will need to be patient-centered to address each individual’s symptoms and health conditions. Objective laboratory or imaging findings should not be used as the only measure or assessment of a patient’s well-being. Normal laboratory or imaging findings do not invalidate the existence, severity or importance of a patient’s post-COVID conditions. 

 

Clinical Considerations When Evaluating for Long COVID

  • Consider Long COVID in your differential diagnosis if your patients report any symptoms or you observe signs consistent with Long COVID.
  • Ask about history of COVID-19 infection, vaccinations and hospitalization, regardless of whether they had symptomatic illness or a positive laboratory test. A positive SARS-CoV-2 viral test or serologic (antibody) test are not required to establish a diagnosis of Long COVID, but testing can help assess for current or previous infection. Include history of COVID-19 infection in the medical record, using ICD-10 Z86.16 (personal history of COVID-19).
  • Remember that normal laboratory or imaging findings do not invalidate the existence, severity, or importance of a patient’s post-COVID conditions. Avoid minimizing or dismissing symptoms by facilitating a thorough diagnostic evaluation and affirm your patient’s experiences.
  • Remember that Black and Latino New Yorkers have experienced a higher burden of COVID-19, in part because of structural racism and longstanding inequities, which has led to a disproportionate impact in these communities.
  • Document your patients’ diagnoses so that there is a record for covering providers and patients requesting accommodation and disability benefits as well as future research.
    • First add the specific ICD-10 codes associated with the symptoms or conditions related to Long COVID if known, such as: chronic respiratory failure (J96.1-), loss of smell or taste (R43.8); pulmonary embolism (I26.-), shortness of breath (R06.02)
    • Use ICD-10 code U09.9 (post-COVID condition, unspecified), as secondary to the specific condition codes.
    • See ICD-10 and CMS coding guidance for more details.

For many people, the primary goal in managing Long COVID is to improve daily function and quality of life through well-established symptom management strategies. This includes identifying and addressing the most debilitating symptoms using a patient-centered approach and developing a comprehensive rehabilitation plan.


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