AUGUST 6, 2021 NEWS RELEASE
First Long COVID Guidance Statement on Fatigue Released
By American Academy of Physical Medicine and Rehabilitation
ROSEMONT, IL – August 6, 2021 – The American Academy of Physical Medicine and Rehabilitation (AAPM&R)
today released the first in a series of peer-reviewed guidance statements to help physicians make
clinical decisions concerning treatment of Post-Acute Sequelae of SARS-CoV-2 infection (PASC or Long
COVID). It is the first clinical guidance to be issued since the Centers for Disease Control and Prevention
released their interim guidance for healthcare providers on June 14, 2021.
“The guidance statements are generally acceptable approaches to the assessment and treatment of
PASC,” according to Benjamin Abramoff, MD, MS, FAAPMR, Co-Chair of AAPM&R’s PASC Collaborative.
“The recommendations attempt to define practices that meet the needs of most patients in most
circumstances. The ultimate judgment regarding care of a particular patient must be made by the
clinician and patient in light of all the circumstances presented by that patient,” said Dr. Abramoff.
The first fatigue guidance statement is published as an article in the PM&R Journal. AAPM&R will lead
discussions on the education of this guidance through various webinars.
“Fatigue during an acute viral illness is common, however individuals with PASC are often presenting
with long lasting and debilitating fatigue during their recovery. Many individuals seek care from their
clinicians for fatigue following COVID-19, and while fatigue likely improves over time, it can persist
beyond six months. We’re hopeful that this essential guidance will make a significant difference for
persons with long-term COVID symptoms who are experiencing fatigue,” said Talya Fleming, MD,
FAAPMR, co-author of the fatigue guidance statement.
Due to rapidly evolving knowledge on PASC, these guidance statements will be reviewed and revised as
needed as new evidence emerges. Additional guidance statements, including those on cognitive
impairment, breathing discomfort, cardiac and autonomic issues, neuropsychology and pediatrics, will
be published on a rolling basis. Learn more about the background by reading the consensus guidance
methodology paper as well as AAPM&R’s long COVID call to action.
“We are excited to share the best practices and initial guidance on treating PASC-related fatigue. This
was, by its nature, a true team effort and we know it’s a great start in getting information out to
physicians everywhere who may be seeing patients with PASC now and in the coming months. The
timing is particularly crucial as the Delta variant spreads, understanding how to identify and treat PASC-related fatigue is only becoming more crucial. We need clinicians across the country to be able to do this
work to ensure equitable access to care for each of the millions of people suffering,” said Dr. Abramoff.
Since the beginning of 2021, AAPM&R has undertaken comprehensive efforts to support its call for a
national plan to address PASC and the 3 to 10 million Americans it is affecting. In March, the Academy
launched a multi-disciplinary PASC collaborative of experts, led by Drs. Benjamin Abramoff, MD, MS,
FAAPMR, Eric Herman, MD and Jason Maley, MD, to develop clinical guidance to improve quality-of-care
as well as formal education and resources to improve experience-of-care and health equity.
Along with guidance statement development, the collaborative is focused on development of PASC
clinical infrastructure guidance as well. An estimated 80+ clinics have been created, and the
collaborative estimates that each can only handle 10-20 patients per week on average compared to the
millions of people who have symptoms. The need for infrastructure guidance will be critical to the
collaborative’s goals and will support the Academy’s overall call to action.
The American Academy of Physical Medicine and Rehabilitation is the national medical specialty
organization representing more than 10,000 physicians who are specialists in physical medicine and
rehabilitation. PM&R physicians, also known as physiatrists, treat a wide variety of medical conditions
affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. PM&R physicians
evaluate and treat injuries, illnesses, and disability, and are experts in designing comprehensive, patient-centered treatment plans. Physiatrists utilize cutting‐edge as well as time‐tested treatments to
maximize function and quality of life.
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