Cao, Bin, Soriano, Joan B, Wang, Quanyi et al. · The European respiratory journal · 2026 · DOI
This guideline summarizes the best available evidence on preventing and treating long COVID (also called post-COVID syndrome). A large international team of experts reviewed research studies and patient experiences to create 10 practical recommendations for doctors. The main suggestions include using vaccines or antivirals early during acute COVID infection to prevent long COVID, avoiding certain medications that don't help, and recommending probiotics, cognitive behavioral therapy for fatigue, and rehabilitation as helpful treatments.
This guideline provides the first international consensus-based framework for long COVID management, addressing a significant unmet clinical need as ME/CFS and long COVID populations lack standardized treatment protocols. The explicit recommendations against unhelpful or potentially harmful interventions protect patients from ineffective therapies, while evidence-supported suggestions offer clinicians a structured approach to care. For ME/CFS patients specifically, the emphasis on avoiding post-exertional malaise exacerbation during rehabilitation aligns with core disease understanding.
This guideline does not establish that recommended treatments are highly effective—all recommendations carry very low to moderate certainty, meaning high-quality evidence is currently lacking. The guideline cannot determine causality or long-term outcomes, as it synthesizes existing literature which the authors acknowledge is often low methodological quality. It also does not prove that one-size-fits-all approaches work for all patients, as personalization and individual response variation are not fully addressed.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Cao, Bin, Soriano, Joan B, Wang, Quanyi, Al-Aly, Ziyad, Gu, Xiaoying, Wang, Guiqiang, et al. (2026). Clinical practice guideline for long COVID prevention and treatment.. The European respiratory journal. https://doi.org/10.1183/13993003.02611-2025
BibTeX
@article{mecfsatlas-cao-2026-clinical-practice,
author = {Cao, Bin and Soriano, Joan B and Wang, Quanyi and Al-Aly, Ziyad and Gu, Xiaoying and Wang, Guiqiang and Leo, Yee-Sin and Jin, Yang and Shi, Qianling and Ohmagari, Norio and Liu, Enmei and Paredes, Roger and Lu, Hongzhou and Kim, Eu Suk and Zhang, Dingyu and Estill, Janne and Li, Li and Spruyt, Karen and Yang, Weizhong and Wang, Yanjiang and Ran, Maosheng and Luo, Xufei and Zhang, Hui and Xu, Jiuyang and Zhang, Rongling and Zhao, Jungang and Zhao, Junxian and Evans, Rachael A and Jeon, Jaehyun and Peluso, Michael J and Errett, Lee E and Zhang, Wenhong and Chalmers, James D and Chen, Yaolong and Multidisciplinary Working Group on Long COVID Practice Guidelines (MWG-LCPG)},
title = {Clinical practice guideline for long COVID prevention and treatment.},
journal = {The European respiratory journal},
year = {2026},
doi = {10.1183/13993003.02611-2025},
note = {PubMed: 41856572},
url = {https://www.mecfsatlas.com/evidence/cao-2026-clinical-practice},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/cao-2026-clinical-practice
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