The FMS (Federation of Medical Specialists) and the NHG (Dutch College of General Practitioners) support medical specialists and general practitioners in the care of people with post-COVID. They do this by making guidelines available for the diagnosis and treatment of long-term complaints after COVID-19. This involves a bundle of scientifically substantiated advice to support healthcare providers in making medical decisions in daily practice. In addition, to improve the quality and efficiency of care, and to ensure that every patient - regardless of which doctor they end up with - can count on the same, responsible care. Where the FMS guideline focuses on 2nd line care (hospital care), the NHG guideline provides support for healthcare providers in 1st line (general practitioner practices).
New insights
The guideline of the FMS en SMALL with regard to long-term complaints after COVID-19 dates from 2022. Due to new (scientific) insights, it is now considered outdated and will be revised. Realizing a new guideline is a process that normally takes one to two years. Updating an existing guideline usually has a shorter trajectory, depending on the amount of (new) scientific research and the necessary coordination with all parties involved. In the spring of 2025, the process to revise the guidelines on post-COVID was started. The intention is to supplement this with new scientifically substantiated insights from research and literature.
Changing insights
As C-support, we see many developments that have become known since 2022 about possible causes of post-COVID. There is also more insight and knowledge about the various symptoms, about the severity of these symptoms and their impact on daily life and mental health. This includes, for example, insight into symptom clusters that often occur in post-COVID patients, such as PEM (Post-exertional malaise), OI (Orthostatic intolerance) including POTS (Postural orthostatic tachycardia syndrome) and MCAS (Mast cell activation syndrome). More insight into this leads to more targeted advice that must be carefully applied by doctors and paramedics to prevent long-term or irreparable damage. But also to symptom treatments that can lead to a relief of symptoms and thus an improvement in the quality of life. It is important that doctors and paramedics realize that the guidelines are no longer up to date and that some important advice is missing.
Latest insights
Below are some relevant resources that reflect current knowledge and insights of post-COVID. These will be incorporated into the revised FMS and NHG guideline.
- Sports medicine guideline (about treatment for PEM, POTS and dysfunctional breathing)
- NASA Leantest (Bateman Horne Centre, USA))
- Review Nature – 2025 (on underlying theories surrounding post-COVID)
- Article Cell – 2024 (on underlying theories surrounding post-COVID)
- Clinical update Lancet – 2024 (on underlying theories surrounding post-COVID)
- Review Nature – 2023 (on underlying theories surrounding post-COVID)
- Podcast Prisma: what is post-COVID (for general practitioners)
- Webinar post-COVID complaints in general practice (medical education)
- Update knowledge agenda biomedical research post-COVID 2025 (ZonMw)
