Guest article: Dr. med. Antje Gottberg

The initial situation

Long COVID poses great challenges to our healthcare system: A new disease pattern with a high degree of suffering for the patients, for which no established diagnostic, care and therapy concepts are available as yet. The uncertainty among those affected and those treating them is correspondingly great. With its mandate to issue a guideline for the care of patients with Long COVID, the legislature has assigned a complex task to the G-BA. 

Aim of the guideline

From my point of view, the aim of this guideline must be to first clarify the diagnosis as quickly and reliably as possible on the basis of the knowledge that is currently available. Reports from those affected indicate that in some cases, there is still a lack of clarity in the practices about how to proceed, in various respects: On the one hand, those affected report that their complaints are not taken seriously, and are made to appear harmless. On the other hand, in some cases, numerous examinations are carried out by various specialists which are not medically necessary and do not help the patients. These ‘patient odysseys’ need to be avoided.

Symptomatic treatment as a contribution to relief

There is currently no causal treatment available for this disease pattern. However, current data from SHI-accredited physician care indicates that many affected persons with a suspicion of this disease only need the corresponding care for a limited period of time. Even if there is no causal treatment, a therapy oriented towards the individual symptoms can significantly alleviate the complaints and contribute to healing. In the meantime, there are also adjusted rehabilitation concepts for severely affected people that are adapted to their individual capacity and resilience, and which can be very helpful if used correctly.

Coordination as a family-doctor task

In my view, it is therefore crucial that the diagnostic process and the subsequent treatment measures are carried out in a manner that ensures that they are coordinated in the overall view of all complaints and the individual life situation of the patients. As a rule, this can be done best within the framework of family doctor care. Therefore, I see the role of coordinating the necessary examination and treatment steps primarily as the task of family doctors.

Research tasks

Long COVID is also a special challenge for medical research. The development of effective treatment measures that are specifically suitable for the treatment of Long COVID is still in the early stages, and needs to be pushed on through public research funding. I see the special outpatient clinics for Long COVID, most of which are affiliated to universities, as being particularly addressed and responsible here. They should launch significantly more methodologically diagnostically conclusive clinical trials to develop effective treatment approaches. In case of Long COVID, the same basic rules for clinical research and for the use of experimental therapies on humans apply as in all other areas of care. The impatience of the severely affected patients in particular is all too understandable. However, the use of untested and risky therapies is unhelpful, especially for them.