{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:23:28Z","timestamp":1791667408103,"version":"4.3.4"},"reference-count":128,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2025,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In 2021, the American Academy of Physical Medicine and Rehabilitation established the Multi\u2010Disciplinary Post\u2010Acute Sequelae of SARS\u2010CoV\u20102 Infection Collaborative to provide guidance from established Long COVID clinics for the evaluation and management of Long COVID. The collaborative previously published eight Long COVID consensus guidance statements using a primarily symptom\u2010based approach. However, Long COVID symptoms most often do not occur in isolation.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n This compendium aims to equip clinicians with an efficient, up\u2010to\u2010date clinical resource for evaluating and managing adults experiencing Long COVID symptoms. The primary intended audience includes physiatrists, primary care physicians, and other clinicians who provide first\u2010line assessment and management of Long COVID symptoms, especially in settings where subspecialty care is not readily available. This compendium provides a holistic framework for assessment and management, symptom\u2010specific considerations, and updates on prevalence, health equity, disability considerations, pathophysiology, and emerging evidence regarding treatments under investigation. Because Long COVID closely resembles other infection\u2010associated chronic conditions (IACCs) such as myalgic encephalomyelitis\/chronic fatigue syndrome, the guidance in this compendium may also be helpful for clinicians managing these related conditions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Guidance in this compendium was developed by the collaborative's established modified Delphi approach. The collaborative is a multidisciplinary group whose members include physiatrists, primary care physicians, pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical therapists, speech and language pathologists, patients, and government representatives. Over 40 Long COVID centers are represented in the collaborative.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Long COVID is defined by the National Academies of Sciences, Engineering, and Medicine as \u201can IACC that occurs after SARS\u2010CoV\u20102 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.\u201d The current global prevalence of Long COVID is estimated to be 6%. Higher prevalence has been identified among female gender, certain racial and ethnic groups, and individuals who live in nonurban areas. However, anyone can develop Long COVID after being infected with the SARS\u2010CoV\u20102 virus. Long COVID can present as a wide variety of symptom clusters. The most common symptoms include exaggerated fatigue and diminished energy windows, postexertional malaise (PEM)\/postexertional symptom exacerbation (PESE), cognitive impairment (brain fog), dysautonomia, pain\/myalgias, and smell and taste alterations. Holistic assessment should include a traditional history, physical examination, and additional diagnostic testing, as indicated. A positive COVID\u201019 test during acute SARS\u2010CoV\u20102 infection is not required to diagnose Long COVID, and currently, there is no single laboratory finding that is definitively diagnostic for confirming or ruling out the diagnosis of Long COVID. A basic laboratory assessment is recommended for all patients with possible Long COVID, and consideration for additional labs and diagnostic procedures is guided by the patient's specific symptoms. Current management strategies focus on symptom\u2010based supportive care. Critical considerations include energy conservation strategies and addressing comorbidities and modifiable risk factors. Additionally, (1) it is essential to validate the patient's experience and provide reassurance that their symptoms are being taken seriously because many patients have had their symptoms dismissed by loved ones and clinicians; (2) physical activity recommendations must be carefully tailored to the patient's current activity tolerance because overly intense activity can trigger PEM\/PESE and worsened muscle damage; and (3) treatment recommendations should be delivered with humility because there are many persistent unknowns related to Long COVID. To date, there are limited data to guide medication management specifically in the context of Long COVID. As such, medication use generally follows standard practice regarding indications and dosing, with extra attention to prioritize (1) patient preference via shared decision\u2010making and (2) cautious use of medications that may improve some symptoms (eg, cognitive\/attention impairment) but may worsen other symptoms (eg, PEM\/PESE). Numerous clinical trials are investigating additional treatments. The return\u2010to\u2010work process for individuals with Long COVID can be challenging because symptoms can fluctuate, vary in nature, affect multiple functional areas (eg, physical and cognitive), and often manifest as an \u201cinvisible disability\u201d that may not be readily acknowledged by employers or coworkers. Clinicians can help patients return to work by identifying suitable workplace accommodations and resources, providing necessary documentation, and recommending occupational or vocational therapy when needed. If these efforts are unsuccessful and work significantly worsens Long COVID symptoms or impedes recovery, applying for disability may be warranted. Long COVID is recognized as a potential disability under the Americans with Disabilities Act.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n To contribute to the overall health and well\u2010being for all patients, Long COVID care should be delivered in a holistic manner that acknowledges challenges faced by the patient and uncertainties in the field. For more detailed information on assessment and management of specific Long COVID symptoms, readers can reference the collaborative's symptom\u2010specific consensus guidance statements.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.13397","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T10:00:38Z","timestamp":1745316038000},"page":"684-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long\n COVID<\/scp>\n : A compendium statement"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8166-0806","authenticated-orcid":false,"given":"Abby L","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Musculoskeletal Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery Washington University in St. Louis St. Louis Missouri 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