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The Devil is in the Long COVID Details When Assessing Mental Health Symptoms, Says Dr Abby Cheng


Is the patient's low energy related to long COVID-related depression, post-exertional malaise, both? The differential diagnosis is all about nuance, says physiatrist Cheng.

Symptoms of long COVID affect all organ systems and presentations can be both complex and subtle. This includes mental health symptoms

Patient Care asked physiatrist Abby Cheng, MD, an author of the recently released American Academy of Physical Medicine and Rehabilitation's Long COVID Mental Health Consensus Guidance Statement if there are any clinical flags that would help a clinician tease out whether a presentation of depression, anxiety, or other mental health disturbance is related to having had COVID-19, was present before the infection, or is an exacerbation of a pre-COVID-19 symptom.

In March 2021, the American Academy of Physical Medicine & Rehabilitation launched the multidisciplinary Post Acute Sequelae of SARS-CoV-2 (PASC) Collaborative, a cross-discipline group of experts convened to develop clinical guidance that would help improve quality of care for individuals with symptoms related to having been infected with COVID-19. The Academy believes there is a need for focused and ongoing clinical exchange among all members of the medical community to develop and implement appropriate clinical practice for treating all long COVID issues, not just those requiring PM&R intervention.

To date the PASC Collaborative has published 8 consensus guidance statements on the assessment and treatment of complications in patients with post-acute sequelae of SARS-CoV-2. Please take time to review the AAPM&R guidance statements on long COVID-associated cardiovascular complications, cognitive symptoms, breathing discomfort, fatigue, autonomic dysfunction, neurologic symptoms, and manifestation in pediatric patients.

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