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PubMed This is a summary of 15 peer-reviewed journal articles Updated
Primary Care · Long COVID

Building Your Long COVID Care Team

At a Glance

Long COVID care often works best when a supportive primary care provider coordinates specialists chosen for your symptoms. Clinicians should check for delayed worsening after activity before recommending rehabilitation, and standing tests should be supervised for safety.

Navigating the medical system with Long COVID (PASC) can be overwhelming. Because the condition affects multiple organ systems, no single doctor can manage every aspect alone. Instead, the most effective care model is multidisciplinary, where different clinicians work together to address your specific symptom cluster [1][2].

Assembling Your Medical Team

While a dedicated Long COVID clinic is helpful, you can build your own team starting with a supportive Primary Care Provider (PCP) who acts as the coordinator [1]. Depending on your symptoms, your team may include:

  • Rehabilitation Specialists: Physical and occupational therapists can be very helpful members for restoring function and guiding you through pacing. Ensure they screen for Post-Exertional Malaise (PEM) [3][4].
  • Cardiologist: May be necessary if you experience severe chest pain, racing heart (palpitations), or dizziness [5]. They screen for heart inflammation or structural issues [6].
  • Neurologist: Can be essential for severe chronic headaches, sensory changes, or complex autonomic issues [3][7].
  • Pulmonologist: If you have persistent shortness of breath, a lung specialist can evaluate for scarring or asthma [5][6].
  • Mental Health Professionals: Psychologists and social workers can provide crucial support for living with chronic illness. Treating mental health is supportive care, not an assertion that your symptoms are “imaginary” [8][9].

Preparing for Your First Appointment

Long COVID symptoms can be vague and “move around” the body. Bringing objective data to your first visit helps your doctor see the patterns [10].

What to Bring:

  • The Timeline: Write down the date of your initial infection, when symptoms first appeared, and if they have changed or come in waves [10][11].
  • Symptom & Activity Diary: Track your activity alongside your symptoms for 1-2 weeks. Look for a delayed “crash” (PEM) [10][11].
  • Orthostatic Vitals Safety: Ask your clinician for safe, supervised orthostatic testing in the office to check your heart rate when standing. Do not attempt a 10-minute standing test alone at home. A smartwatch cannot establish POTS, and you could faint or injure yourself [9][12].
  • Past Test Results: Bring copies of any blood work, ECGs, or imaging you have already had [13].

Vetting Your Care Team

It is important to ensure your team understands the unique nature of this condition, particularly regarding activity.

Watch for these “Green Flags”:

  • They ask about your “energy envelope” and screen you for PEM before suggesting exercise [14].
  • They validate that your symptoms are real and focus on functional goals (e.g., “being able to grocery shop”) [2][15].

Watch for these concerns:

  • They recommend fixed “Graded Exercise Therapy” (GET) or tell you to “push through” the fatigue if you have PEM [14].
  • They dismiss your symptoms entirely. Clinicians should appropriately assess for anxiety or deconditioning—as they are treatable and often coexist with chronic illness—but they should not use them to explain away Long COVID without a proper workup [2][1].

Common questions in this guide

Who should be the main coordinator for my Long COVID care?
A supportive primary care provider can serve as the main coordinator, track your overall symptoms, and arrange referrals. A dedicated Long COVID clinic can also provide coordinated care, but you can build a team with your existing clinicians.
Which specialists might I need for Long COVID?
The right team depends on your symptoms and may include rehabilitation professionals, a heart specialist for chest pain or a racing heart, a neurologist for headaches or sensory changes, and a lung specialist for ongoing shortness of breath. A psychologist or social worker can also provide support for living with chronic illness.
What should I bring to my first Long COVID appointment?
Bring a timeline of your COVID-19 infection and symptoms, a one- to two-week diary of activity and symptoms, and copies of previous blood tests, heart tracings, or scans. Note whether symptoms worsen 12 to 48 hours after activity, which can help your clinician assess delayed crashes.
Can I do a standing test at home to check for POTS?
Do not perform a 10-minute standing test alone at home because you could faint or injure yourself. Ask a clinician to perform the check in a supervised setting, because a smartwatch alone cannot diagnose POTS.
How can I tell whether a provider understands Long COVID?
A supportive provider asks about your energy limits and delayed symptom worsening after activity before recommending exercise or rehabilitation. They validate your symptoms, set practical functional goals, and assess anxiety or physical deconditioning without using those issues to dismiss Long COVID.
What should I ask about exercise if I have post-exertional malaise?
Ask how the clinician will screen for post-exertional malaise before recommending physical activity and how pacing can be adjusted to your energy limits. If you have this delayed crash, a fixed plan that tells you to push through fatigue may not be appropriate, so discuss individualized goals.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.What is your approach to screening for Post-Exertional Malaise (PEM) before recommending any physical activity or rehabilitation?
  2. 2.Can we safely perform an orthostatic vitals check in the office today?
  3. 3.How do you coordinate care between specialists, and who will be my 'point person' for adjusting treatments if my symptoms flare?
  4. 4.What criteria do you use to determine if I need a referral to a cardiologist or neurologist?
  5. 5.If I experience a significant crash or worsening of symptoms, what is the best way to communicate with your office for urgent guidance?

Questions For You

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References

References (15)
  1. 1

    Long COVID-19 and primary care: Challenges, management and recommendations.

    Ahmed S, Ahmad E, Ahmad B, et al.

    Semergen 2024; (50(3)):102188 doi:10.1016/j.semerg.2023.102188.

    PMID: 38306758
  2. 2

    Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic Biomarkers and Risk Factors.

    Parums DV

    Medical science monitor : international medical journal of experimental and clinical research 2024; (30()):e946512 doi:10.12659/MSM.946512.

    PMID: 39289865
  3. 3

    The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection.

    Moghimi N, Di Napoli M, Biller J, et al.

    Current neurology and neuroscience reports 2021; (21(9)):44 doi:10.1007/s11910-021-01130-1.

    PMID: 34181102
  4. 4

    The Female-Predominant Persistent Immune Dysregulation of the Post-COVID Syndrome.

    Ganesh R, Grach SL, Ghosh AK, et al.

    Mayo Clinic proceedings 2022; (97(3)):454-464 doi:10.1016/j.mayocp.2021.11.033.

    PMID: 35135695
  5. 5

    Cardiovascular symptom phenotypes of post-acute sequelae of SARS-CoV-2.

    Mahmoud Z, East L, Gleva M, et al.

    International journal of cardiology 2022; (366()):35-41 doi:10.1016/j.ijcard.2022.07.018.

    PMID: 35842003
  6. 6

    Breathless Aftermath: Post-COVID-19 Pulmonary Fibrosis.

    Muthiah D, Vaddadi K, Liu L

    Viruses 2025; (17(8)) doi:10.3390/v17081098.

    PMID: 40872813
  7. 7

    Cognitive functioning in patients with neuro-PASC: the role of fatigue, mood, and hospitalization status.

    Cahan J, Finley JA, Cotton E, et al.

    Frontiers in neurology 2024; (15()):1401796 doi:10.3389/fneur.2024.1401796.

    PMID: 38994492
  8. 8

    Postural orthostatic tachycardia syndrome as a sequela of COVID-19.

    Ormiston CK, Świątkiewicz I, Taub PR

    Heart rhythm 2022; (19(11)):1880-1889 doi:10.1016/j.hrthm.2022.07.014.

    PMID: 35853576
  9. 9

    Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?

    Bisaccia G, Ricci F, Recce V, et al.

    Journal of cardiovascular development and disease 2021; (8(11)) doi:10.3390/jcdd8110156.

    PMID: 34821709
  10. 10

    The other COVID-19 survivors: Timing, duration, and health impact of post-acute sequelae of SARS-CoV-2 infection.

    Lambert N, , El-Azab SA, et al.

    Journal of clinical nursing 2024; (33(1)):76-88 doi:10.1111/jocn.16541.

    PMID: 36181315
  11. 11

    Persistence of Post-Acute COVID-19 Sequelae (PASC) symptoms in healthcare workers four years after ancestral SARS-CoV-2 infection: a prospective multicentre cohort.

    Saurer P, Ballouz T, Cusini A, et al.

    Infection 2026; (54(3)):1407-1418 doi:10.1007/s15010-026-02768-0.

    PMID: 41845161
  12. 12

    Can consumer wearables support outpatient health monitoring for patients with post-acute infection syndromes? A systematic umbrella review of accuracy, validity, and clinical utility data.

    Kaplan DM, Kessler N, Pozzo NS, et al.

    PLOS digital health 2026; (5(6)):e0001124 doi:10.1371/journal.pdig.0001124.

    PMID: 42258488
  13. 13

    Multidisciplinary Center Care for Long COVID Syndrome-A Retrospective Cohort Study.

    Bailey J, Lavelle B, Miller J, et al.

    The American journal of medicine 2025; (138(1)):108-120 doi:10.1016/j.amjmed.2023.05.002.

    PMID: 37220832
  14. 14

    Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.

    Cheng AL, Herman E, Abramoff B, et al.

    PM & R : the journal of injury, function, and rehabilitation 2025; (17(6)):684-708 doi:10.1002/pmrj.13397.

    PMID: 40261198
  15. 15

    The Use of a Handheld Non-Invasive Vagal Nerve Stimulation (nVNS) Device for the Treatment of Long COVID: A Pilot Randomized Controlled Trial.

    Ganesh R, Yadav S, Schroeder DR, et al.

    Journal of primary care & community health 2026; (17()):21501319261473073 doi:10.1177/21501319261473073.

    PMID: 42501005

This page is for informational purposes only and does not constitute medical advice. Your clinician should evaluate your symptoms, supervise orthostatic testing, and coordinate care based on your needs.

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