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Research ArticleEvidence-Based Clinical Medicine

Addressing Post-COVID Symptoms: A Guide for Primary Care Physicians

Heather Vance, Amelita Maslach, Emily Stoneman, Kathryn Harmes, Andrea Ransom, Katharine Seagly and Wendy Furst
The Journal of the American Board of Family Medicine November 2021, 34 (6) 1229-1242; DOI: https://doi.org/10.3122/jabfm.2021.06.210254
Heather Vance
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Amelita Maslach
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Emily Stoneman
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Kathryn Harmes
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Andrea Ransom
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Katharine Seagly
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Wendy Furst
From University Health Service, University of Michigan, Ann Arbor (HV); Primary Care Clinic, University Health Service, University of Michigan, Ann Arbor (AM); Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor (ES); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (KH); University Health Service, University of Michigan (AR); Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor (KS); Department of Family Medicine, University of Michigan Medical School, Ann Arbor (WF).
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Abstract

Background: Post-COVID symptoms, defined as symptoms lasting >4 weeks postinfection, have been identified not only among those patients who were hospitalized with severe symptoms but also among those who were asymptomatic or with only mild symptoms. Primary care providers (PCPs) will often be the first point of contact for patients experiencing potential complications of post-COVID symptoms. The aim of this article is to present a post-COVID management tool for PCPs to use as a quick reference and guide to the initial workup and management of the most common post-COVID symptoms.

Methods: Published guidance, recent literature, and expert specialist opinion were used to create the structure outlining the outpatient evaluation and treatment for post-COVID symptoms.

Results: A quick-reference guide for management of post-COVID symptoms was created for PCPs. Educational materials were created for clinicians to share with patients. Our article reviews several common complaints including respiratory, cognitive, and neurological symptoms, chronic fatigue, dysautonomia, and anosmia and presents recommendations for management.

Conclusions: Data on long-term effects of COVID-19 are still emerging, and rapid dissemination of this data to front-line PCPs is crucial. This table was our effort to make the currently available evidence accessible for our PCPs in a simple, easy-to-use format.

  • COVID-19
  • Long-COVID
  • Multidisciplinary Communication
  • Patient Care Team
  • Primary Health Care
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The Journal of the American Board of Family   Medicine: 34 (6)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 6
November/December 2021
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Addressing Post-COVID Symptoms: A Guide for Primary Care Physicians
Heather Vance, Amelita Maslach, Emily Stoneman, Kathryn Harmes, Andrea Ransom, Katharine Seagly, Wendy Furst
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1229-1242; DOI: 10.3122/jabfm.2021.06.210254

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Addressing Post-COVID Symptoms: A Guide for Primary Care Physicians
Heather Vance, Amelita Maslach, Emily Stoneman, Kathryn Harmes, Andrea Ransom, Katharine Seagly, Wendy Furst
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1229-1242; DOI: 10.3122/jabfm.2021.06.210254
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