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AAPM&R Long COVID Neurological Symptoms Guidance Statement Announced

May 16, 2023

Today, we announced new guidance for diagnosing and treating common symptoms of neurological complications from Long COVID. The statement was developed by AAPM&R's PASC Collaborative, a multidisciplinary group of physicians, clinicians and patient advocates convened to address the pressing need for guidance in caring for patients with Long COVID.

Long COVID remains a long-term public health issue. New data suggests antiviral treatments for COVID-19 may help prevent Long COVID, but millions of Americans still suffer from symptoms of Long COVID.

Long COVID symptoms are varied, ongoing and are often experienced in clusters. The most common neurologic Long COVID symptoms include headaches, weakness, muscular numbness, pain, tremors and palsy.

“Identifying patients with progressive or ominous "red flag" neurological symptoms is essential for emergent triaging,” said Dr. Leslie Rydberg, co-author of the neurology Long COVID guidance statement. “These symptoms may be due to Long COVID versus another medical condition, but a history and physical examination is essential.” She added that patients should be evaluated if neurological symptoms are not improving one month after acute symptom onset.

Patients who seek earlier evaluation, diagnosis and symptom management can improve with beneficial interventions. Outpatient physical and occupational therapy benefits Long COVID patients, but there remain significant gaps in health equity for certain populations. Physiatrists see the whole patient AND the whole picture of the rehabilitation ecosystem and help individuals recover quicker and more fully. 

These statements are part of a multidisciplinary collaborative consensus guidance series for the most predominant Long COVID symptoms, published in AAPM&R's PM&R Journal. The first consensus guidance on fatigue was released in August 2021, followed by guidance on breathing discomfort and cognitive symptoms in December, cardiovascular complications in June 2022 and pediatrics and autonomic dysfunction in September. An additional consensus guidance statement on Long COVID in mental health will be published next.

Please join us in sharing this guidance with your colleagues to support patients. Learn more.