Frequently Asked Questions Overview
Post-COVID
Yes. New biomedical insights show that physical dysregulation can occur in the immune system, the nervous system, and energy metabolism, among others. This provides a better explanation for symptoms such as severe fatigue and exercise intolerance.
Yes. There is a leaflet in simple language and a poster in simple language available. An animation has also been created explaining the information corresponding to that in the leaflet. You can view it via this link . It explains what Long COVID / post-COVID is, what symptoms most people have, what C-support and PostCovid NL can help with, and what they can do for a patient.
Yes. There is information in 11 different languages about what Long COVID / post-COVID is, what symptoms most people have, what C-support and PostCovid NL can help with, and what they can do for a patient. This can be found at www.c-support.nu/talen . There is also a toolkit with materials for non-native speakers and people with low literacy. This can be found here: www.c-support.nu/toolkit-voor-communicatie-in-meerdere-talen/ . If desired, C-support arranges a telephone interpreter service when in contact with someone who is a non-native speaker.
No, there is (as yet) no test to demonstrate post-COVID. That is why it is important to rule out another medical cause or explanation for your symptoms before talking about post-COVID. That is why you should always visit your GP first.
Research shows that 1 in 8 people infected with COVID develop long-term symptoms (post-COVID). Estimating the exact number of post-COVID patients is difficult because there is no national registry. The MIT report assumes 450.000 patients, of whom 90.000 have severe long-term symptoms. This also includes children and adolescents.
Yes. Post-infectious conditions such as post-COVID, ME/CFS, Q fever and Lyme disease show certain similarities with each other. Similar complaints:
- Extreme fatigue
- PEM (complaints after physical and mental exertion)
- Dysautonomia (nervous system dysregulation)
- Muscle and joint complaints
- Poor quality of sleep
Dysautonomia is an umbrella term used to describe various conditions that cause a disruption of the autonomic nervous system. The autonomic nervous system then does not function properly. There are various causes of dysautonomia, including post-infectious syndromes (such as post-COVID and QFS), ME/CFS, but also, for example, Parkinson's disease. Dysautonomia occurs primarily in women. View our page on the different forms of dysautonomia here for more information.
PEM stands for Post Exertional Malaise, which refers to a worsening of symptoms following (over)exertion. Symptoms can arise acutely or develop 12–48 hours after physical, cognitive, and/or emotional exertion. These symptoms can persist for days or, in some cases, weeks. Exhaustion occurring a considerable time after the exertion is particularly typical. View our page on PEM here for more information.
'POTS' stands for Postural Orthostatic Tachycardia Syndrome. This occurs more frequently in post-COVID patients. This means that the heart rate suddenly increases sharply upon a change in position (for example, from a lying to a standing position). This is often accompanied by various other symptoms (including palpitations, fainting, headache, and fatigue). This indicates a dysfunction of the autonomic nervous system . View our page on POTS here for more information.
MCAS is a condition in which mast cells in the body activate inappropriately and release substances. This causes a wide range of symptoms that often resemble allergic reactions. Examples include skin complaints such as redness and itching, circulatory complaints such as low blood pressure and fainting, gastrointestinal complaints such as abdominal cramps and diarrhea, respiratory complaints such as a stuffy nose or itching in the nose, and other symptoms such as fatigue, concentration problems, and a general feeling of illness. View our page about MCAS here for more information.
When health changes permanently, many people experience Living Loss: recurring grief over what is no longer taken for granted. People with post-infectious conditions sometimes lose parts of their health, daily abilities, social roles, or future plans. This loss is often unpredictable, intense, and not always visible to the outside world. Loved ones also experience changes in their lives and roles, which can likewise evoke feelings of loss in them.
We have a here Factsheet made about that offers more information Espaitec's made of which an aftercare advisor discusses this with an expert. Furthermore, it is possible to a previously recorded webinar You can view the video on this topic from sister organization Q-support, in which Manu Keirse, Grief Expert and Emeritus Professor at the Faculty of Medicine of the Catholic University of Leuven, shares more about Living Loss. And Gerda van Hemert, a psychosocial therapist specializing in grief, discusses how you can cope with this.
PEM and POTS are by now concepts familiar to most general practitioners and specialists. This knowledge will certainly be included in an update of the guidelines. We do not know when these updates are scheduled. It is the task of the various professional associations to adapt the guidelines. Naturally, C-support does share knowledge regarding this. It is known that it has been included in the guidelines for occupational physicians and sports physicians.
There is not yet much scientifically substantiated knowledge regarding post-COVID and pregnancy. However, recommendations from an article in The Lancet have been translated into the Dutch context. See this link to Post-COVID and pregnancy for more information.
Can post-COVID increase the risk of thrombosis?
Research shows that the risk of thrombosis, such as a blood clot in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism), can remain elevated for some time after a SARS-CoV-2 infection. This increased risk is primarily seen in the first three to six months after infection and applies not only to people who have been seriously ill, but can also occur in those with persistent symptoms consistent with post-COVID [1]. This doesn't mean that everyone with post-COVID will develop thrombosis, but it does mean that it's important to be alert to symptoms that could indicate this.How can thrombosis develop post-COVID?
In post-COVID, various processes in the body can remain disrupted for a longer period. Scientific research describes that the lining of blood vessels, the so-called endothelium, can remain activated or damaged for a long time after a SARS-CoV-2 infection. As a result, the blood vessel partially loses its protective function against clotting [2,3]. Furthermore, there are indications that the blood in some people retains an increased tendency to clot for a long time, which can be reflected in elevated clotting values for months after the infection [3]. Persistent inflammation likely also plays a role, as inflammatory processes can continue to activate the clotting system. Finally, inactivity or prolonged lying down, which are common in post-COVID cases, can further increase the risk of thrombosis.What can you do yourself to reduce the risk?
Although thrombosis cannot always be prevented, there are measures that can help reduce the risk. Regular exercise is important, even if it only occurs briefly. It is best to avoid sitting or lying still for long periods by, for example, moving around briefly every hour. Drinking enough fluids helps to make the blood less viscous. For people who are (partially) bedridden, regularly moving their feet and legs in bed can contribute to better blood circulation. In some situations, wearing support stockings can be helpful, but this should always be done in consultation with a doctor or healthcare provider. It is important not to use blood thinners without medical advice.When should you contact your GP?
It is important to contact your GP the same day if you experience symptoms such as a suddenly swollen, painful, or warm calf or leg, or if you experience new, unexplained shortness of breath. In the event of severe and sudden symptoms, such as severe shortness of breath, chest pain, fainting, coughing up blood, or sudden loss of function such as a crooked mouth or speech problems, you should call 112 immediately. Healthcare professionals should here more information about anticoagulation in post-COVID.Sources [1] Katsoularis I. et al. Risk of venous thromboembolism following COVID-19. BMJ, 2022. [2] Crook H. et al. Long COVID: mechanisms, risk factors and management. Journal of Medical Virology, 2021. [3] Jing Z. et al. Long COVID: pathophysiological mechanisms and therapeutic strategies. Signal Transduction and Targeted Therapy, 2022.
Treatments
We regularly receive questions from post-COVID patients about the off-label use of SSRIs. Look here for more information about the use of SSRIs.
We regularly receive questions from post-COVID patients about the off-label use of LDN. Look here for more information about the use of LDN.
Paxlovid is registered in the Netherlands for the group of high-risk patients, to reduce the chance of a more serious acute course of a COVID infection (hospitalization, ICU admission or death) in the event of (re)infection. At this time, there is insufficient scientific evidence that starting Paxlovid in people with post-COVID, at the time of (re)infection, leads to a less serious course or relapse. That is why post-COVID is not included in the group of high-risk patients who have an indication to receive this at the time of (re)infection. There is also no scientific basis for using Paxlovid for the treatment of post-COVID, although this is currently being investigated. In the Netherlands, there is currently no possibility for people with post-COVID to qualify for Paxlovid on an individual basis, with the help of a general practitioner or another doctor.
Doing activities in a controlled manner can be helpful; an occupational therapist can advise you on this. Watch these videos about energy and recovery.
Yes, that is possible. Fighting the complaints and not being able to accept them costs energy. Energy that is badly needed to recover. We often notice that if people accept the situation and can 'surrender' more to the complaints, this benefits the recovery. However, simply accepting the complaints does not ensure that the complaints are gone and the patient is better again. So, as mentioned, it is helpful but not healing. Our aftercare advisor can advise you further in the process of accepting complaints. There are also training courses available (e.g. ACT).
Hyperbaric oxygen therapy is a treatment in which you inhale 100% oxygen through a mask at a pressure that is higher than the normal ambient pressure. This takes place in a large space in which the pressure can be increased. Due to the increased pressure, your body can absorb approximately 12,5 times as much oxygen in the blood plasma as normal. The tissues that receive too little oxygen receive more oxygen as a result. The treatment ensures that, among other things, new blood vessels grow, pain symptoms decrease and immune cells work better. It is an intensive treatment that usually consists of 30-40 sessions of 2 hours, for 6-8 weeks. It seems that some patients can improve, but relapse after treatment is also known.
NOTE: This treatment has not yet been proven effective and is not covered by health insurance. Research is currently underway. here the latest update.
In the long term, it could potentially provide a solution for patients with long-term cognitive impairment. More scientific research is needed to prove that this therapy can work in post-COVID.
NOTE: This treatment has not yet been proven effective and is not covered by health insurance. However, (international) research is currently underway. Read more here the latest update.
No, this therapy is not reimbursed for post-COVID. The effectiveness of this treatment has not yet been proven. Research is currently being conducted (internationally).
Costs vary widely. 40 treatments cost thousands of euros and are at your own expense.
NOTE: This treatment has not yet been proven effective and is not covered by health insurance. However, (international) research is currently underway. Read more here the latest update.
No, C-support cannot provide referrals. We only offer advice; for medical referrals, please contact your general practitioner or specialist. Referrals to clinics for hyperbaric oxygen therapy for the treatment of post-COVID are possible; however, the effectiveness of this treatment has not yet been proven and is not reimbursed by health insurance. Research is currently being conducted into this. Read the latest update here.
Vaccinations
Yes, that is possible. Each year, the target groups for whom the vaccine is made available are determined. It is recommended that people with vulnerable health who are at greater risk of a serious infection (severe acute course of illness with increased risk of hospitalization, ICU admission or death) and healthcare workers who work with these vulnerable people. There are no indications that people with post-COVID have a high risk of hospitalization, ICU admission or death due to corona, which is why they do not fall under the target group. However, people who want a vaccination for individual reasons can make an appointment at the GGD for a vaccination.
Based on scientific research, the RIVM (National Institute for Public Health and the Environment) has determined that vaccination should be given to groups at higher risk of serious illness, hospitalization, and death from COVID-19. These are people aged 60 and over and younger people with underlying health conditions who also receive the invitation for the annual flu shot. These are people with heart or lung disease, diabetes, kidney disease, or other conditions that weaken their immune system. For people with post-COVID-19 infections, a disrupted immune response likely plays a role, but there is currently insufficient evidence that they are more likely to experience a more severe course of the acute illness (i.e., a higher risk of hospitalization, ICU admission, or death) upon re-infection. Therefore, post-COVID-19 is not an indication for vaccination. An exception to this is the group of people who have demonstrable lung damage (as assessed by CT scan and/or lung function) from a previous COVID-19 infection. This also includes people who developed asthma after their previous COVID-19 infection. These two groups are also being invited for flu vaccinations by the Municipal Health Service (GGD).
The reaction to a vaccination can vary each time. It is therefore difficult to predict whether and which side effects you will develop after vaccination. Most complaints after vaccination are mild and short-lived. The most common side effects are fever, fatigue, headache, and muscle pain . Research has since shown that vaccination can also affect post-COVID symptoms. In most cases, vaccination does not have a major effect on existing symptoms, although this is difficult to predict on an individual basis. Improvement of symptoms in general occurs more frequently than worsening of symptoms. The choice of whether or not to vaccinate remains, of course, an individual decision and is personal. If you decide to vaccinate, ensure a good balance between activity and rest in the days surrounding the vaccination.
Very limited research has been conducted on this, with mixed results. Patient experiences indicate that vaccination sometimes has a (temporary) influence on post-COVID symptoms, both positively and negatively. However, reinfection also carries a risk of (temporary) deterioration. The decision to vaccinate or not remains an individual consideration and is personal. If you are still unsure about (re)vaccination, you can always consult with your treating physician and/or C-support. You can also call the Doubt Hotline , available daily between 8:30 AM and 1:00 PM at 088-7 555 777 (also in English, Turkish, and Arabic).
No, if you are otherwise healthy, you will not receive an invitation for the annual flu shot. Only older people aged 60 and over and younger people with underlying diseases will receive an invitation. An exception to this is the group of people who have demonstrable lung damage (by a CT scan and/or lung function) after a previous corona infection. This also includes people who have developed asthma after their previous COVID-19 infection.
If you would like to get the flu shot because you are afraid that the flu could worsen your long-term symptoms, you can discuss this with your GP. Often, if there are sufficient vaccines available at your GP or pharmacy, you can get a flu shot at your own request. This will incur costs for you. A flu shot only helps against getting sick from the influenza virus. There are also many other cold viruses in circulation. The flu shot does not protect against these.
- Practice good hand hygiene and ask your household members and visitors to do the same.
- Avoid contact with people who have symptoms consistent with a respiratory infection (such as coughing, sneezing, sore throat and a runny or runny nose).
- If contact is necessary, remember to wear a face mask, practice extra hand hygiene and sneeze or cough into your elbow.
- Ensure adequate ventilation of indoor areas.
Work and Income
Request a second opinion from another occupational physician. Do this in consultation with your aftercare advisor. Furthermore, you can refer the occupational physician to the NVAB (your own professional association) Guidelines for Occupational Physicians, which contain explanations, views, and practical tools for occupational physicians regarding people with post-COVID symptoms.
It is important to find a good balance between the workload and your own resilience. To support you in this you can:
- Online training SterQ at work
- Watch this one videos about energy and recovery
- View information, tips and tools on the Method
You will have to report yourself (partly) sick to your employer. The Gatekeeper Improvement Act sets out all the steps that you and your employer must take.
If you have reported sick, you and your employer must take steps to ensure that you can return to work. This is called reintegration. The rules that you and your employer must adhere to are set out in the Gatekeeper Improvement Act (Wet verbetering poortwachter). You are obliged to cooperate with your reintegration. Together with your employer, you are responsible for keeping your absence as short as possible and for expediting your reintegration.
- More information can be found at our website and the website of the UWV.
- Watch this one animation about the Gatekeeper Improvement Act
- Also take a look at the Method for all people with an infectious disease.
The occupational expert is a specialist in the field of people, work and income. He or she often comes into the picture after the first-year evaluation in which the company doctor has drawn up an employability profile (IZP) stating what the possibilities are. The occupational expert translates the burden of your function into the capacity as determined by the company doctor. The occupational expert then goes through the following 4 questions:
- is your own work appropriate?
- Can your own work be made suitable with adjustments/facilities?
- Is there any other suitable work within the organization?
- Are there any other suitable opportunities outside the organization?
WIA stands for: Work and Income Act based on Work Capacity. If, after being (partially) ill for two years, you are still unable to work (partially), you will be subject to the WIA.
- View the information at this website
- Watch this short animation;
- Frequently asked questions about WIA and Long COVID
- You can read more about the WIA on the Method
No. Specific occupational or medical expertise is required to prepare medical reports. For this, you can call upon one of the many consultancy firms . Ask your legal advisor at your trade union, the Legal Aid Office, or your legal assistance insurer which consultancy firms you can consult. C-support does not carry out these expert assessments itself. However, your aftercare advisor can help you find the right path.
Children and young people
PAIS is an umbrella term for conditions that can develop following an infection. These include post-COVID, Q fever fatigue syndrome (QFS), ME/CFS, chronic Lyme disease and other tick-borne diseases, post-Sepsis syndrome (PSS), and post-Legionella syndrome (PLS). Children with PAIS may experience long-lasting symptoms that severely limit their daily functioning.
Yes. New biomedical insights show that physical dysregulation can occur in the immune system, the nervous system, and energy metabolism, among others. This provides a better explanation for symptoms such as severe fatigue and exercise intolerance.
The severity of post-COVID varies from child to child. In fact, they all suffer from hypersensitivity to crowds, noise, light, and other stimuli. Some children can attend school or participate in activities to a limited extent, while others are largely housebound. In severe cases, children may even become bedridden and be unable to tolerate any stimuli at all.
There is no reason to assume that. The symptoms of PAIS are real and can be severely debilitating. It is important to carefully investigate symptoms and not to jump to unfounded conclusions too quickly.
Children with Long COVID fall under authorized absence. The youth doctor, also known as the school doctor, is the designated person to formulate a recommendation based on consultations with the parents, the student, the school, and any advice from an occupational therapist. A statement regarding work capacity is not necessary. The work capacity of a child with Long COVID can vary significantly from day to day and week to week. If a statement indicates that the work capacity has a specific duration and a child experiences a relapse (or PEM ), a written statement regarding work capacity can put parents in a difficult position.
Advice based on insights from the youth doctor who coordinates this with the child or young person, parents, school and if necessary in consultation with therapists and the truancy officer is sufficient for compulsory education. Together we can look at whether and how appropriate participation in education can be resumed. See also advice on school participation after corona measures expire.
The youth doctor works within a youth healthcare team and collaborates with the neighborhood team. In the event of long-term absenteeism due to illness, the school contacts the youth healthcare service (JGZ), and parents can also submit questions there. The youth doctor is bound by medical confidentiality. If necessary, the youth doctor can, with the permission of the student and parents, request information from the treating physician of the young person and/or the vulnerable family member.
The term resilience is not always used consistently by professionals at school, youth health care, and compulsory education. It therefore regularly leads to discussion. That is why this document drawn up to clarify the role of the JGZ in assessing the resilience of sick-reported young people.
For questions about psychological and social problems:
- Digital Help Guide: points the way in psychological and social problems in various domains where questions arise, including:
- Need a listening ear
- Help with personal problems
- Meaningful life and social assistance
- Youth Health Care (JGZ): within a municipality, the JGZ is concerned with the health, development and growth of your child. You can go here for free advice, information, basic medical care and support in growing up and raising children. This also includes the Consultation Bureau for children aged 0-4 and GGD Youth Health Care for children aged 4-18.
- Center for Youth and Family (CJG): offers help and advice on parenting issues. It is a place where parents, children and professionals can go with questions about health, growing up and parenting.
- Youth help online: here you will find more than 20 helplines that offer you fast, anonymous and free support. Via chat, phone or email. Reliable and professional.
- Mentally vital: (part of the Trimbos Institute) provides information about mental health, offers exercises and helps you find help.
For questions about educational support:
- Network Ziezon: support for sick children in education. The network also offers a lot of knowledge and information for parents, teachers, school boards and partnerships.
- Parents & Education: information about education and more for parents with school-age children.
- Partnership for appropriate education: information about appropriate education, the working methods and additional support options for parents with school-age children.
- Carefree to School Foundation – practical tips: tailor-made at school for pupils (primary/secondary education) and students (vocational education) with a chronic illness. Here is a your guides with tips for making practical arrangements with the school.
- Carefree to School Foundation – distance learning: distance learning options for pupils/students who can only attend school/training for a few hours. With a route map for students for whom distance learning could be a good solution.
- OZL – Educational Support for Sick Students: looking for opportunities to offer sick students the right form of education. Regional care: educational support in Gelderland, Brabant and Limburg.
- Educational consultants: if parents have a dispute with the primary care facility (collaboration), they can contact an education consultant. This person supports the advocacy of the child and talks to parents, school, municipality and/or collaboration to find solutions and appropriate care.
- NJI educational care arrangement: especially for children who need educational and care support, there is a collaboration between education and youth care and parents. The development of the child at school is central. Educational-care arrangements are available for individual children and for groups of children.
For questions about development support:
- Youth care under the Youth Act: for children and young people there is the Youth Act. This act regulates almost all care and support for children and young people under the age of 18. Here you can find out how to apply for youth care and what it entails. Sometimes care for young people is also provided under the Health Insurance Act, the Long-term Care Act or the Wmo.
- Regulation assistance Wmo youthDoes your child have an illness, disability (such as severe multiple disabilities), or developmental delay? Then various forms of help and support are available.
- Wlz care for youth: the Long-term Care Act regulates care for people who need lifelong and life-wide support, at home or in a care institution. Children and young people can also receive Wlz care if they meet the conditions.
- Integrated Early Help: for questions about developmental delays and/or behavioral problems in young children up to 8 years of age.
So far, there are no known medical treatments, in the treatment of the cause of Long COVID, that are scientifically proven. Paramedical recovery care may contribute to recovery and relief of complaints. For children, the possibilities are (child) occupational therapy, physiotherapy, speech therapy, dietetics and psychological guidance. In this case, it is highly recommended to work with care providers who have knowledge of Long COVID.
- There are children with Long COVID who are struggling with PEM of POTS where gradual build-up is not possible. Exertion leads to worsening of the symptoms.
- The seriously disabling limitations that arise from physical complaints can lead to psychological complaints, not the other way around.
- Scientific research in children Overview of studies on COVID-19, MIS-C and Children.
- ZonMW research on children – VINCERE study Long COVID complaints in children and their impact on daily functioning are mapped. The final analysis also examines whether vaccination has (had) an effect on Long COVID complaints. Original project description
- RIVM research Research among families and young people about the course of the disease.
- Guidelines Dutch Association for Pediatrics (NVK) This describes the diagnosis and treatment of children with Long COVID. An update of the guideline is currently being worked on.
The latest knowledge regarding various PAISs is not yet fully integrated into Dutch care and support. As a result, some families receive advice or assessments that do not align with current scientific insights. This can lead to misunderstanding, frustration, and a loss of trust.
It is important to take into account the limitations or complaints of a child or young person. C-support can assist you by sharing information about post-COVID with a third party. You can ask the school to contact us about this. Discuss the possibilities with your aftercare advisor. You can also contact a consultant from Onderwijsgroep Zieke leerlingen OZL.
If you disagree with the school regarding the necessary support or the transfer of your child to special (primary) education, you can take action. For more information, visit oudersenonderwijs.nl or onderwijsconsulenten.nl.
Prolonged fatigue, school absenteeism, numerous medical complaints, and reluctance towards certain treatments can sometimes be mistakenly viewed as signs of neglect or falsification. However, these phenomena can actually be characteristic of a PAIS. It is important to distinguish between falsification and PAIS clinical pictures.
[Falsification is a form of child abuse in which a child's complaints are fabricated, exaggerated, or caused by a parent or caregiver. This is a very rare situation (prevalence estimated at 0.4-2 per 100.000 children).]
Misinterpretation of symptoms can lead to unnecessary stress for the child and the family, as stress is a known trigger for relapse or worsening of symptoms in children with PAIS. Unfounded suspicions of unsafety can cause significant harm. Therefore, good listening, asking follow-up questions, an open attitude, and knowledge of PAIS are essential.
In the event of a Veilig Thuis report, it is appropriate to always engage in a conversation with Veilig Thuis, no matter how unjustified the report may feel. For more information about their working methods, visit veiligthuis.nl. Tips:
- Get well informed about what the report is about. Try to discuss unexplained complaints that arise from Long COVID and/or areas where this has an effect. Explain what this looks like and what this does to your child.
- Always remain in conversation with the relevant agency that Veilig Thuis uses to investigate whether and what kind of help is appropriate. For example, a neighborhood team, youth worker or social worker. This is not there to work against you, but to jointly look at possibilities that can be helpful.
- You can at the BIVKZ right with questions. They represent the interests of parents and chronically, seriously ill or care-intensive children at VT Notifications in the Netherlands.
File formation Safe at Home:
Veilig Thuis is legally obliged to enter into a conversation with the directly involved parties within 5 working days. If the suspicions are not correct and there are no concerns about safety (domestic violence or child abuse), the report is refuted and Veilig Thuis ends its involvement. There are then no further steps. The reporter is informed whether or not the report will be processed. If Veilig Thuis itself enters into a conversation with the family or household, Veilig Thuis always provides feedback to the reporter at the end of its involvement. The file will be retained unless an active request is made to destroy the file. In subsequent reports, it is always checked whether there is already a file. If there is a file and the report has been refuted and no steps have been taken as a result, no new investigation will be conducted. A file is kept for 15 years.Schedule a periodic progress meeting at school to evaluate progress and make agreements regarding the adapted education to be followed. The occupational therapist and/or treating physician of your child or young person can support you in this, within the framework of personal capacity. Ziezon can support your child at school. When a student has a long-term, chronic, or life-threatening condition with (potential) consequences for their school career, it is possible to engage a Consultant for Education of Sick Students (OZL) . This consultant can provide temporary help and guidance to the school, the parents, and the student. The OZL consultant provides care for or supports with, among other things:
- contact between school, hospital, student and parents;
- information and advice to teachers about teaching sick students;
- information for teachers, parents, (healthcare) professionals and classmates about dealing with sick pupils;
- education and guidance of the sick pupil at home, in hospital and at school;
- (organizing) lessons at home or in the hospital together with the school, if the school's own teachers are unable to do this;
- information about diseases and their possible consequences for school performance;
- creating an action plan for the sick student together with the school.
NB: There are children and young people who are unable to go to school or to build up activities. The advice given in this answer does not apply to this group of children.
The school has a duty of care as soon as a pupil is registered in writing (from age 3). When a pupil is enrolled at a school and parents register at another school, the school where the child was most recently registered has the duty of care. Parents of pupils who need extra support are sometimes referred from one school to another without a school admitting their child, because there is no written registration yet. This is undesirable and also has consequences. Read on the website of the Education Inspectorate what the school's duty of care entails.
According to the Appropriate Education Act, schools must realize appropriate education in the most efficient and effective way possible for all students who need extra support. Under this law, schools are responsible for finding a suitable place for these students, the so-called duty of care. The appropriate education duty of care has 3 goals:
- clearly assigning responsibilities;
- relieve parents;
- prevent staying at home.
- the own school;
- another regular school if the school of choice cannot provide the necessary assistance;
- a school for special primary education;
- a school for special education;
- or other special provision.
It is often an individual battle between parents and school, for recognition of post-COVID complaints and for Appropriate Education. What are these children entitled to? What care is there for these children?
- In consultation with the education consultant who is connected to your child's school, the possibilities for appropriate education are discussed. Think of home education, class contact, KPN home education, extra support for children with an educational disadvantage, possibly by a remedial teacher.
- If the school is unable to act, which means that it cannot provide appropriate education and/or your child has suffered too great an educational disadvantage, a referral to special education (SO Cluster 3) will be advised. In the case of seriously ill children, there are no taxable possibilities. For example, PEM of POTSIn that case, any reference has no added value.
- Inquire at the WMO counter in your municipality to find out which facilities your child is entitled to.
- Parents of chronically ill children can apply for double child benefit at the social insurance bank.
- For young people there is a provision for the performance grant in special circumstances: a special arrangement in the event of illness or disability.
- On the website mbotoegankelijk.nl en www.hogeronderwijstoegankelijk.nl contains information about studying with a disability or chronic illness and information about what facilities are available. There is also information on www.regelhulp.nl
- If you are still able to study, but you are no longer able to work in addition to your studies, you may be eligible for a apply for a study grant in your municipality.
- Network Ziezon – brochure for teachers about Long COVID: advice regarding education for students who struggle with this.
- Lesopsence.nl: organizing distance education. Intended for school leaders and teachers.
- Support Center for Appropriate Education: supports schools in implementing appropriate education in practice.
- Education and Development Netherlands: Onderwijsontwikkeling Nederland is the association of consultancy firms for education. The members of Onderwijsontwikkeling Nederland form a close-knit, nationwide network.
- Care for children and young people Mental Health Care: for primary school teachers who deal with psychological problems in children.
Tips for professionals in education and care. It is important to:
- to listen to the child and the family openly and without prejudice;
- to take into account fluctuating load capacity;
- to recognize signs of post-exertional malaise (PEM);
- to carefully weigh medical causes;
- to collaborate with parents and involved care providers;
- to be cautious with assumptions about motivation, upbringing, or safety;
- to explain post-COVID in the classroom, in coordination with the child regarding naming their own situation;
- In case of doubt, consult healthcare providers specialized in PAIS.
Log in to C-support
Unfortunately, you can no longer sign up for support from C-support. C-support will cease operations at the end of 2026.
Yes, there is a waiting time. Check this page for the current waiting times.
No, you do not pay any costs for the assistance you receive from C-support. If your aftercare advisor recommends occupational therapy, physiotherapy, or other treatments, always contact your health insurer. They can tell you more about the reimbursements you receive for specific care.
Yes, you can still submit a new request for help to us until November 1, 2026. You can contact us via Solvio, but you can also use this contact form for patients. We will then contact you.
Online file Solvio
Yes, you can submit a request to have your file deleted. You can find more information about this here (pages 19 and 20).
Solvio works easiest on your laptop or PC. C-support has created the following manuals:
- Create an account in Solvio
- Solvio PC or laptop
- Solvio mobile devices
No, you do not have to pay anything for Solvio.
It is possible that you have forgotten your password or that your Solvio password no longer works after a period of time. Due to security policy, Solvio requests that you create a new password after a period of inactivity of 6 months. In both cases, you can create a new password by taking the following steps:
- Go to the Solvio login page and click on the link 'I can no longer log in'.
- Enter your username or email address and click 'Submit'.
- You will receive an email that will allow you to reset your account.
- Go to the login page of Solvio.
- Enter your username and password and click the Login button.
- You will receive a verification code via email or a special app. This is a personal code that provides additional security to your account.
- Enter the verification code and click the Verify button.
First, view the 'creating an account in Solvio' manual on this page of our website . Check the frequently asked questions on the Solvio website to see if the answer to your question is listed there. If you do not find the answer, please contact the Solvio helpdesk: 050 210 02 55. The helpdesk is available Monday to Friday from 08:00 to 18:00. Solvio staff cannot assist you with substantive questions, as they do not have access to your file. In that case, please contact the C-support secretariat: 0734400440. The secretariat is available Monday to Thursday from 09:00 to 12:30 and from 13:30 to 16:30, and on Friday from 09:00 to 12:30.
Contact your aftercare advisor to send a new link. Do you no longer have your aftercare advisor's phone number? Then call the secretariat (on working days) at 073 4400 440 ; they will connect you.
Personal overview questionnaire
We know that many patients appreciate the personal overview and would like to have it to explain to others what is going on with them. Preparations for the questionnaire were already well advanced, enabling us to provide everyone with a personal overview this year.
After completing the questionnaire, the personal overview will be available in Solvio the same day. You will receive a notification when it is ready in Solvio.
Everyone aged ≥ 16 who is registered with C-support and Q-support (with an active file and residing in the Netherlands). This concerns people with: post-COVID, long-term symptoms after COVID-19 vaccination, Q fever fatigue syndrome (QFS), and chronic Q fever.
The questionnaire is not suitable for children and adolescents. Due to the closure of our organization, we are unfortunately no longer able to develop a questionnaire for this group.
Yes, you can give permission for your data to be used only for the personal overview, optimizing care and support, and sharing knowledge with (healthcare) professionals.
Yes, you can stop your participation and withdraw your consent at any time. In this case, please send an email to: po@c-support.nu . In the email, state that you are withdrawing your consent. You do not need to explain why you are stopping. The data used cannot be retrieved or destroyed. This data will remain available anonymously to the person conducting the research.
The questionnaire data will be used for:
- compiling your personal overview;
- compiling average personal overviews;
- optimizing care and support and sharing knowledge;
- conducting scientific research in collaboration with other parties. For this we ask you for permission separately.
That is not yet known. We are retaining the data for future scientific research in collaboration with other parties such as universities and hospitals. This will involve research into the nature and course of post-COVID, Q fever, complaints after vaccination, or other post-infectious conditions (PAIS):
- research that can lead to a better diagnosis;
- research enabling the course to be predicted more accurately;
- research that can contribute to the development of new treatments.
No, data is transferred anonymously; your name, address, and contact details are not shared. Your anonymous data is shared only after you have given your consent.
- You can do the questionnaire in parts. Save the results after a few questions and continue at a later time. You can return to the questionnaire with the link from the invitation. Continue where you left off.
- Ask someone to read the questions out loud and fill in your answers for you.
Yes, that is possible. However, we advise you to use a laptop or PC. Preferably use Google Chrome.
(Healthcare) professionals
Background
In some patients with post-COVID-19, evidence has been found for persistent changes in the coagulation system for months after acute SARS-CoV-2 infection [1,3]. Observational studies show that the risk of venous thromboembolic complications may remain elevated in the post-acute phase, particularly in the first three to six months after infection [3]. At the same time, there is considerable heterogeneity between patients and a lack of robust interventional research supporting routine anticoagulation in post-COVID-19 [1,2].Pathophysiological considerations
Jing et al. describe that some post-COVID patients experience persistent endothelial inflammation and impaired blood clotting, which may contribute to a long-term increased risk of thrombosis [2]. In addition, elevated D-dimer levels are described in a subgroup for up to four to twelve months after infection, possibly related to persistent inflammation and immunothrombosis [2]. Crook et al. place these findings in a broader context of long-term vascular and inflammatory dysregulation after COVID-19, in which endothelial damage, inflammation, and coagulation activation mutually reinforce each other [1].Therapeutic implications
Jing notes that based on these findings, anticoagulation seems an obvious treatment option, but clinical trials are needed to develop concrete recommendations [2]. Currently, there are no randomized controlled trials supporting routine prophylactic anticoagulation in post-COVID [1,2]. Results from studies in acute COVID-19 or post-hospital discharge cannot simply be extrapolated to patients with post-COVID in the primary care or chronic phase [2].Clinical policy
Based on current knowledge, routine anticoagulation in post-COVID patients without additional risk factors is not recommended [1,2]. Anticoagulation can be considered in individual patients with a clear indication, such as a previous venous thromboembolism, active malignancy, severe immobility, or a combination of significantly elevated coagulation markers and clinical risk factors [2,3]. Antiplatelet therapy, such as acetylsalicylic acid, is not recommended without an existing cardiovascular indication [1,2]. In clinical practice, vigilance and easily accessible diagnostics in suspected thrombosis are preferred over prophylactic treatment [1]. Additionally, it is advisable to identify and, where possible, treat other thrombotic risk factors.Ready to see how Snowflake works?
Post-COVID-19 can be associated with long-term prothrombotic changes, but it remains unclear whether anticoagulation is a meaningful intervention [1–3]. Decision-making should be individualized and risk-driven.Sources [1] Crook H. et al. Long COVID: mechanisms, risk factors and management. Journal of Medical Virology, 2021. [2] Jing Z. et al. Long COVID: pathophysiological mechanisms and therapeutic strategies. Signal Transduction and Targeted Therapy, 2022. [3] Katsoularis I. et al. Risk of venous thromboembolism following COVID-19. BMJ, 2022.
We regularly receive questions from healthcare providers about the off-label use of LDN in post-COVID patients. This is often prompted by a patient asking their GP or general practitioner to prescribe the medication. As a healthcare professional, look here for more information on the use and prescribing of LDN.
Yes. There is a leaflet in simple language and a poster in simple language available. An animation has also been created explaining the information corresponding to that in the leaflet. You can view it via this link . It explains what Long COVID / post-COVID is, what symptoms most people have, what C-support and PostCovid NL can help with, and what they can do for a patient.
Yes. There is information in 11 different languages about what Long COVID / post-COVID is, what symptoms most people have, what C-support and PostCovid NL can help with, and what they can do for a patient. This can be found at www.c-support.nu/talen . There is also a toolkit with materials for non-native speakers and people with low literacy. This can be found here: www.c-support.nu/toolkit-voor-communicatie-in-meerdere-talen/ . If desired, C-support arranges a telephone interpreter service when in contact with someone who is a non-native speaker.
We have contact with a number of academic hospitals about scientific research that is ongoing there. Furthermore, our medical advisors contact the treating physicians in the hospital, if necessary. They always do this in consultation with the patient.
Yes, that is possible. Fill out the contact form here . One of our medical advisors will then contact you.
Patients can register themselves with C-support via our website, you do not need to refer them. Patients who still have complaints more than three months after a Covid-19 infection can register with us. We provide advice if, for example, there are questions about persistent complaints, recovery care or problems at work. We do not provide direct medical treatment.
Termination of services
Q-support and C-support are dependent on subsidies from the Ministry of Health, Welfare and Sport. Although funding is available for 2027, it remains unclear what this means for our support and what is expected of us in return. Moreover, the funding is for a single year and is significantly lower than in previous years. This means that we would have to make drastic adjustments to our support in the short term and subsequently phase it out. Due to this combination of uncertainty, limited time, and lower funding, we cannot responsibly continue providing our support. We would then be unable to offer what patients and professionals need: clarity and support they can rely on. As an organization, we also face obligations towards employees, ongoing processes, contracts, systems, and files. A careful phase-out takes time. Therefore, we have had to make the difficult decision now to cease services provided by Q-support and C-support at the end of 2026.
For proper support, it is important that we can provide patients, professionals, and staff with clarity regarding what we can offer, how long we can do so, and under what conditions. Currently, there is insufficient clarity on this matter. Therefore, it is not responsible to proceed.
No. The decision to terminate Q-support and C-support at the end of 2026 is final.
New patients can register until August 1st. Patients who are already registered with us can contact us with their questions until November 1st. Are you in contact with an aftercare advisor? If so, your aftercare advisor will discuss with you what you need, what we can still offer in the coming period, and what other support is possible.
New patients can register until August 1, 2026. Patients who are already registered but currently have no contact with an aftercare advisor, yet have a question or need support, can contact us until November 1, 2026.
The regular care and support field remains important for care and support. Think of your general practitioner, therapist, municipality, employer, occupational physician, or other involved organizations. By October at the latest, we will provide patients with further information regarding organizations they may be able to turn to for support after 2026.
We understand that this decision may cause concern. Do you have an aftercare advisor? Please discuss your concerns with him or her. Together, you can look at what is needed in your situation and what support is required. If you do not have contact with an aftercare advisor but do have questions, you can still contact us until November 1st via our telephone number or the contact form on the website.
You can continue to use, view, and download or print reports from your file in the usual way. Unfortunately, it is currently not possible to download your entire file at once; we are working on a solution to make this possible. From November 1st, the option to download the entire file from Solvio will become available. If you wish, you can share your data yourself with a healthcare provider or other involved parties. At the end of the year, we will ensure a careful closure of your file, in accordance with GDPR guidelines. You will receive more information about the closing of your file no later than October.
Yes, you can submit a request to have your file deleted. You can find more information about this here (pages 19 and 20).
Over the past few years, a great deal of knowledge and experience has been built up. We believe it is important that this knowledge is not lost. Therefore, we will remain committed until the end of 2026 to documenting knowledge and transferring it to other parties, and to keeping it available as much as possible for patients and professionals.
We understand that many patients and professionals would like the information on our websites to remain available. Therefore, the information on our websites, in fact sheets, and in other materials will remain available for the coming months. Additionally, we are committed until the end of 2026 to carefully documenting the knowledge and experience we have built up over the past years and transferring it to other parties.
Following the termination of Q-support and C-support, there is no longer an organization that can manage, maintain, and update our websites. It is particularly important for patients and professionals that information remains reliable and up-to-date. Insights into post-infectious diseases are constantly evolving. If information is no longer updated, there is a risk that patients and healthcare providers will end up with outdated information or that various sources will continue to exist side by side, which can cause confusion.
Therefore, we consider it important to transfer our knowledge, expertise, and the content of websites and materials as effectively as possible to parties who can manage and update this information in the future. The exact details of how this will be implemented will be further developed in the coming period. As soon as there is more clarity on this, we will inform patients and professionals. In this way, we aim to contribute to ensuring that patients and professionals maintain access to current and reliable information.
We consider it important that data is handled carefully. We will be working out the response to this in the coming period. Naturally, the rules regarding privacy and consent apply in doing so.
Professionals can still make use of our knowledge sharing and peer consultation in the coming months.
Training sessions and presentations will be held until 1 November 2026 and can be requested until 1 September 2026. Peer consultation is possible until 1 December 2026.
In addition, information on the website, fact sheets, and other materials will remain available over the coming months.
We have offered the Ministry of Health, Welfare and Sport to help consider the allocation of the available funds for 2027.
You can still contact Q-support or C-support via the known contact details in the coming months if you have questions about your support.
Didn't find an answer to your question?
Ask your question directly via our contact form. You will receive an answer from one of our specialists as soon as possible.
