Diagnosing and Managing Long COVID Symptoms in Practice: Noah Greenspan, DPT

Long COVID has been an ongoing health concern in the United States since the end of the pandemic. Yet, diagnosing it is a consistent hurdle many physicians and patients face, often under- or over-diagnosing patients and missing the root of the issue.¹

Many patients present with symptoms resembling those of other respiratory and pulmonary conditions, like shortness of breath and fatigue. However, their treatment, like other respiratory conditions, requires individualized treatment regimens to address the root of patients’ symptoms and administer an effective treatment, which varies patient to patient, said Noah Greenspan, DPT, a board-certified clinical specialist in cardiovascular and pulmonary therapy and owner and founder of Pulmonary Wellness Complex PT!.

“To me, [long COVID patients] kind of respond like the majority of complex cardiovascular and pulmonary patients,” Greenspan said in an interview with The American Journal of Managed Care®. “If somebody had a heart attack, if somebody had a pneumonia that was severe, if somebody had lung cancer, they would probably respond in the same way, which is that we would see someone who's extremely debilitated, and there would be a slow, long recovery.”

Long COVID is defined by many health organizations as a continuation of COVID-19–related or respiratory symptoms that persist more than 4 to 6 weeks after initial infection. Yet, even with this definition, diagnosing patients is still difficult. Since working with long COVID patients, Greenspan has identified treatments and strategies that mitigate and sometimes alleviate symptoms altogether with consistent therapy.

“We've found that compression socks are very, very helpful,” he said. “[And] we found that electrolyte supplementation throughout the day is very, very helpful.”

In addition to thigh-high compression socks and consistent electrolyte intake, rest is one of the biggest suggestions, especially with patients who may tend to “overdo it” before their body is fully capable, Greenspan said. Nevertheless, the road to recovery is long and slow, requiring patience from both practitioners and patients alike.

References
1. McCrear S. FAQ: how long COVID is defined, diagnosed, and managed in 2026. AJMC. February 26, 2026. Accessed March 9, 2026. https://www.ajmc.com/view/faq-how-long-covid-is-defined-diagnosed-and-managed-in-2026