Interventions | Arche Infographics

This infographic is about:

Pharmacological and
Non-Pharmacological Interventions for Post COVID-19 Condition

(also known as long COVID)

What is PCC

I have post COVID-19 condition (PCC) — what can I do to help take care of my symptoms?

Post COVID-19 condition (also known as long COVID) usually appears within three months from an acute COVID-19 infection and lasts at least two months.

Symptoms (e.g., brain fog, fatigue, shortness of breath, pain) vary, can change or worsen over time, and significantly impact daily life, according to the World Health Organization.

There are various ways to take care of your symptoms, including both pharmacological and
non-pharmacological interventions

A pharmacological intervention is when medicine is used to take care of a health condition. This can include prescription drugs from a healthcare provider or over-the-counter medication that you can buy at the store.

What is a pharmacological intervention?

A non-pharmacological intervention is when something other than medicine is used to take care of a health condition. This can include rest, pacing yourself, exercise, therapy (e.g., physical therapy), or other lifestyle changes (e.g., nutrition, sleep) to help with symptoms.

What is a non-pharmacological intervention?

Some people may use both types of interventions to manage their symptoms.

People with PCC may have different symptoms, so management may be different for each person.

Which intervention type is right for you?

About CAN-PCC

Raising awareness about PCC: what has been done and how can you take care of your symptoms?

The Canadian Guidelines for Post COVID-19 Condition (CAN-PCC) Collaborative has developed guidelines on pharmacological and non-pharmacological interventions for PCC to help in the management of symptoms. There are a number of recommendations to help adults make informed decisions about their health.

To see a full list of recommendations and good practice statements on pharmacological and non-pharmacological interventions for PCC in adults, click here.

What is a guideline?

What is a recommendation?

Click here to learn more.

Recommendations

What are some CAN-PCC recommendations for pharmacological and non-pharmacological interventions for PCC?

Pharmacological Interventions

Mast cell activation syndrome (MCAS) is a condition that causes a person to have several allergy-related symptoms (e.g., itchy skin, red eyes, stuffy or runny nose, difficulty breathing), in multiple body systems.

We suggest that adults with PCC who also have symptoms of MCAS may want to talk to their healthcare provider about the use of antihistamines, as they may benefit from antihistamine treatment.

Postural orthostatic tachycardia syndrome (POTS) is a condition in which patients experience a fast heart rate and dizziness when they stand up. They may also experience fatigue, a drop in blood pressure, or other symptoms.

Inappropriate sinus tachycardia (IST) is a condition that involves fast heartbeats, and can also include dizziness and loss of consciousness.

We suggest that adults with PCC who also have POTS or IST may want to talk to their healthcare provider about the use of ivabradine, beta-blockers, pyridostigmine, or midodrine, as they may benefit from these medications.

Healthcare providers will determine the main sign or symptom to guide selection of treatment medication:

For fast heart rate: ivabradine or beta-blockers
For dizziness or low blood pressure: midodrine or pyridostigmine

For adults with PCC and no active COVID-19 infection, current evidence does not suggest the use of the following medications, unless they have another condition that require them, like mast cell activation syndrome (MCAS). Always check with a healthcare provider to see which medications are safe and suitable:

nirmatrelvir/ritonavir (also known as Paxlovid)
molnupiravir
remdesivir
low-dose naltrexone
antihistamines
corticosteroids (e.g., intranasal, inhaled)
antiplatelet drugs (i.e., used to stop platelets, a type of blood cell, from clumping and forming clots)

If an adult has PCC and also an active COVID-19 infection, they should talk to a healthcare provider about whether the following medications may help with their symptoms or improve outcomes. Healthcare providers can guide them on which medications are safe and appropriate, since each medication has its own benefits, risks, and costs:

metformin
nirmatrelvir/ritonavir (also known as Paxlovid)
molnupiravir
remdesivir

A healthcare provider is the best person to help decide which medications are safe and suitable.

Learn more about choosing between nirmatrelvir/ritonavir (Paxlovid), remdesivir, or molnupiravir

Learn more about choosing between metformin or nirmatrelvir/ritonavir (Paxlovid)

Non-pharmacological Interventions

We suggest that adults with PCC who experience post-exertional malaise (PEM), also known as post-exertional symptom exacerbation (PESE), may want to rest and pace themselves. The goal of resting and pacing is to conserve energy to manage fatigue (e.g., take breaks often, listen to your body, do not push yourself, spread your activities over time).

PEM/PESE is a condition where a person’s symptoms become worse after doing ordinary physical, mental, emotional or social activities. PEM/PESE can be triggered up to 48-72 hours after activity. Symptoms may include fatigue, brain fog, headaches, and trouble sleeping. Symptoms can last from days to months.

If an adult does not experience PEM/PESE, we suggest that they may want to use activity, movement, or exercise therapies to help improve physical functioning and quality of life. Exercise therapies should be tailored to each person. There are different types of exercises with varying intensities (e.g., breathing exercises, aerobic exercises). Before starting, screen for PEM symptoms and keep an eye on these symptoms before, during and after activity.

More research is needed to determine whether exercise therapies are safe and effective for adults with PCC and PEM.

To see a full list of recommendations and good practice statements on pharmacological and non-pharmacological interventions for PCC in adults, click here.

Additional Support

Talk to a healthcare provider about which recommendations may be right for you

It is important to talk to a healthcare provider so they can support you and make a care plan that is right for you. Everyone’s symptoms and needs are different, so what worked for one person may not work for everyone.

Here are some tips to guide your conversation:

Remember, your healthcare provider is there to help you, so do not be afraid to ask questions and ask for clarification if you need it. If you have any concerns or need more help, your healthcare provider is the best person to give you personalized health advice that is right for you.

"It’s been 12 months since my symptoms started. I feel like I am slowly getting better. It has not been easy. My healthcare provider is supporting my medical journey. My family and friends are providing emotional comfort."

00:00 / 00:14

Ask for help and seek support from others

Asking for help and seeking support from others can bring comfort, shared experiences, and other advice that a healthcare provider may not be able to offer. A supportive community can encourage you and help you at each part of your PCC journey, making those challenging days feel easier to handle.

“I just want to talk to more people that get it because I'm so tired of talking to people who don't.“

— Person with lived PCC experience

There is also an online resource available called ‘Get Started with MyGuide: Long COVID’ that can help inform, equip and empower you in your journey with PCC.

Get started with MyGuide: Long COVID

MyGuide: Long COVID is a customizable guide for individuals who experience PCC symptoms, or those wanting to learn about recovering from lingering symptoms after a COVID-19 infection.

Visit the other guideline topics to learn more about:

Prevention of post COVID-19 condition

Pediatric and adolescent topics

Testing, identification, and diagnosis related to post COVID-19 condition

More Resources

More resources

Canadian Guidelines for Post COVID-19 Condition | CAN-PCC

Resources for Patients and the General Public | CAN-PCC

Post COVID-19 Condition | Government of Canada

Get started with MyGuide: Long COVID | Provincial Health Services Authority

Long COVID Web

COVID and Mental Health | Canadian Mental Health Association

Antiplatelet Drugs:

Antiplatelet drugs are used to stop platelets, a type of blood cell, from clumping and forming clots. These drugs are often used to lower the risk of heart attack and stroke.

IST:

Inappropriate Sinus Tachycardia (IST) is a sinus heart rate over 100 beats per minute (bpm) at rest, with a mean 24-hour heart rate of over 90 bpm not due to identifiable causes, and is associated with distressing symptoms of palpitations.

MCAS:

Mast cell activation syndrome (MCAS) is a condition that causes a person to have several allergy-related symptoms in multiple body systems.

PEM/PESE: Post-exertional malaise (PEM), also known as post-exertional symptom exacerbation (PESE), is a condition where a person’s symptoms become worse after doing ordinary physical, mental, emotional or social activities. PEM/PESE can be triggered up to 48-72 hours after activity. Symptoms may include feeling more tired, having brain fog, headaches, trouble sleeping, and others. Symptoms can last from days to months.

POTS:

Postural orthostatic tachycardia syndrome (POTS) is a common autonomic nervous system disorder characterized by an excessively fast heart rate and symptoms of lightheadedness upon standing.

Taurine:

Taurine is a natural amino acid found in the body. It is also in foods like meat, fish, and eggs, and can be bought as a supplement.

CAN-PCC Disclaimer

Last Updated: 12-MAR-2025

Pharmacological and
Non-Pharmacological Interventions for Post COVID-19 Condition

(also known as long COVID)

I have post COVID-19 condition (PCC) — what can I do to help take care of my symptoms?

There are various ways to take care of your symptoms, including both pharmacological and
non-pharmacological interventions

What is a pharmacological intervention?

What is a non-pharmacological intervention?

Which intervention type is right for you?

Raising awareness about PCC: what has been done and how can you take care of your symptoms?

What are some CAN-PCC recommendations for pharmacological and non-pharmacological interventions for PCC?

Pharmacological Interventions

Should I take any medications if I have symptoms of mast cell activation syndrome (MCAS) such as itchy skin or red eyes?

Should I take any medications if I have postural orthostatic tachycardia syndrome (POTS) or inappropriate sinus tachycardia (IST)?

Are there medications that can manage my other symptoms if I do not have MCAS, POTS or IST?

Non-pharmacological Interventions

Should I be doing any movement-based activities or therapies?

Should I take a taurine supplement?

Talk to a healthcare provider about which recommendations may be right for you

Here are some tips to guide your conversation:

Prepare your questions

Talk about what you have tried to help take care of your symptoms

Talk about how to take care of your symptoms and the cost

Talk about a follow-up plan

Take notes

Ask for help and seek support from others

Visit the other guideline topics to learn more about:

Prevention of post COVID-19 condition

Pediatric and adolescent topics

Testing, identification, and diagnosis related to post COVID-19 condition

More resources

Definitions

Pharmacological and Non-Pharmacological Interventions for Post COVID-19 Condition

(also known as long COVID)

I have post COVID-19 condition (PCC) — what can I do to help take care of my symptoms?

There are various ways to take care of your symptoms, including both pharmacological and non-pharmacological interventions

What is a pharmacological intervention?

What is a non-pharmacological intervention?

Which intervention type is right for you?

Raising awareness about PCC: what has been done and how can you take care of your symptoms?

What are some CAN-PCC recommendations for pharmacological and non-pharmacological interventions for PCC?

Pharmacological Interventions

Should I take any medications if I have symptoms of mast cell activation syndrome (MCAS) such as itchy skin or red eyes?

Should I take any medications if I have postural orthostatic tachycardia syndrome (POTS) or inappropriate sinus tachycardia (IST)?

Are there medications that can manage my other symptoms if I do not have MCAS, POTS or IST?

Non-pharmacological Interventions

Should I be doing any movement-based activities or therapies?

Should I take a taurine supplement?

Talk to a healthcare provider about which recommendations may be right for you

Here are some tips to guide your conversation:

Prepare your questions

Talk about what you have tried to help take care of your symptoms

Talk about how to take care of your symptoms and the cost

Talk about a follow-up plan

Take notes

Ask for help and seek support from others

Visit the other guideline topics to learn more about:

Prevention of post COVID-19 condition

Pediatric and adolescent topics

Testing, identification, and diagnosis related to post COVID-19 condition

More resources

Definitions

Pharmacological and
Non-Pharmacological Interventions for Post COVID-19 Condition

There are various ways to take care of your symptoms, including both pharmacological and
non-pharmacological interventions