Tom Kobel

Tom Kobel
06.10.2021

In the last few weeks medical Long COVID guidelines have been published in Germany and Italy. In a time of uncertainty, when definitive study results are still missing, this is an essential aid for the treating physicians.

This is also helpful for those affected by Long COVID: In Germany, a special patient guideline was published in September.

This gives professionals a verified summary of current knowledge, symptoms, research situation and treatment options.

Such guidelines serve as a valuable orientation aid and have various advantages: they are easy to read, understandable and compact. Thanks to additional references, they are nevertheless comprehensive and contain clearly identified recommendations. As “living guidelines” they are revised periodically.

The German guideline is structured according to subject areas. General medical, cardiological, neurological or pediatric aspects are dealt with. There is a separate chapter for fatigue and pain. Open questions and thus current knowledge gaps are also named for each subject area.

No Swiss publication yet

In Switzerland, we are not yet aware of any published guidelines from a specialist society. The medical network mediX has published a factsheet (in German) with an overview of symptoms, diagnostics, warning signals and possible interventions. Recommendations for the insurance law assessment of long COVID cases are currently being worked on.

Guidelines in two languages

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Guidelines from Germany:

Guidelines from Italy:

In the case of the patient guideline, some of the authors are affected physicians themselves. In addition, self-help groups have contributed significantly to its development. With questions like "What is fatigue and what can I do about it?" or "After physical or mental stress, I suddenly feel very bad a short time later. How does that come about and how can I deal with it?" the patient guideline are designed to be very close to everyday life. A glossary is also available.

The sender of the two German guidelines is the “Working Group of Scientific Medical Societies” (AWMF). The AWMF coordinates the development of scientific guidelines for diagnostics and therapy in Germany.

In the introduction of the German guidelines, the panel of experts emphasized that Long COVID is a complex clinical picture that requires “an interdisciplinary approach with a view to the whole person, as well as continuity in care”.

So far no clear biomarkers

In the document it is also stated that Long COVID can currently neither be diagnosed or objectified by a single laboratory test nor by a specific selection of laboratory values. Correspondingly, the possibility of other causes for the complaints should also be considered and, if necessary, ruled out.

Conversely, inconspicuous laboratory values by no means rule out a Long COVID syndrome. Diagnosing Long COVID remains a complex matter.