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First Long COVID Guidance Statement on Fatigue Released By American Academy of Physical Medicine and Rehabilitation | NEWS-Line for Occupational Therapists & COTAs

First Long COVID Guidance Statement on Fatigue Released By American Academy of Physical Medicine and Rehabilitation


The Academy of Physical Medicine and Rehabilitation (AAPM&R) 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 after recovery. Many individuals are seeking 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 long COVID patients 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.

Source: American Academy of Physical Medicine and Rehabilitation

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