Long COVID in the Pharmacy: Recognition, Referral, and the Role of Vaccination

Millions of people have recovered from COVID-19, but for many, the infection was not the end of the illness: It was the beginning of a chronic condition commonly referred to as long COVID (LC). LC's diverse clinical manifestations and associated diagnosable conditions have contributed to the absence of a clear, standardized definition.¹ Patients with persistent, unexplained symptoms are walking into pharmacies every day, potentially living with unidentified LC. By recognizing common symptom clusters, facilitating referrals to appropriate health care providers, and educating patients about the risk-reduction benefits of COVID-19 vaccines, pharmacists can play a pivotal role in improving patient outcomes.²

In 2024, the National Academies of Sciences, Engineering, and Medicine developed a working definition of LC.¹ Also known as the post-acute sequelae of COVID-19 or post–COVID-19 syndrome, this chronic condition is associated with a prior SARS-CoV-2 infection. Persisting for at least 3 months, LC follows a continuous, relapsing-and-remitting, or progressive course, affecting one or more organ systems.¹ Table 1 summarizes LC’s notable features.

Both the CDC and the World Health Organization list more than 200 symptoms of LC.^3,4 Its variable presentation and lack of a true diagnostic test make treatment considerably difficult.¹ Ongoing research suggests that LC may be characterized by distinct phenotypes or recurring symptom clusters, which—if identified—could significantly improve current management strategies. A 2026 systematic review summarized potential subtypes. Table 2 lists the 5 most prevalent organ-system–associated symptom clusters identified by the study.⁵

When patients report these persistent symptoms, ask one simple question: "Did these symptoms begin after you had COVID-19?" An affirmative answer should prompt consideration of long COVID and appropriate referral.²

The COVID-19 vaccine has consistently proven useful for limiting the severity of acute infection and reducing visits to hospitals and urgent care facilities. A recent study estimated that the 2025-2026 COVID-19 vaccine decreased the risk of COVID-19–related hospitalization by 55% and emergency department or urgent care visits by 50% among adults 18 years and older who received a vaccine this past season.⁶ Receiving a COVID-19 vaccine seems to lower the risk of developing LC. A systematic review and meta-analysis of the COVID-19 vaccination’s impact found patients who received the primary vaccination series and additional boosters had a statistically significant lower number of LC symptoms, a lower prevalence, and a lower overall risk of LC compared with unvaccinated or less-vaccinated patients.⁷

The clinical pearls included in Table 3 highlight practical strategies pharmacists can use to mitigate the consequences of active or future LC cases.²

Although a great deal of progress has been made, significant research is still necessary for the scientific community to fully grasp the complexity of LC. Without an identifiable cure for LC, health care providers must prioritize prompt diagnosis and individualized, evidence-based symptom management.⁸ By offering competent, convenient care to patients, pharmacists can reduce stress in other areas of the health care system and further demonstrate their dynamic, often untapped potential.²

About the Author

Jack J. Vinciguerra is a PharmD from Glastonbury, Connecticut.

REFERENCES

1. Ely EW, Brown LM, Fineberg HV; National Academies of Sciences, Engineering, and Medicine Committee on Examining the Working Definition for Long Covid. Long Covid defined. N Engl J Med. 2024;391(18):1746-1753. doi:10.1056/NEJMsb2408466

2. Gosser R, Anderson S, Blaszczyk A, Jen C, Bhatt S. In it for the long haul: post-acute sequelae of severe acute respiratory syndrome coronavirus 2. J Pharm Pract. 2023;36(5):1048-1051. doi:10.1177/08971900221088799

3. Long COVID basics. CDC. May 6, 2026. Accessed July 9, 2026. https://www.cdc.gov/long-covid/about/index.html

4. Post COVID-19 condition (long COVID). World Health Organization. February 26, 2025. Accessed June 24, 2026. https://www.who.int/news-room/fact-sheets/detail/post-covid-19-condition-(long-covid)

5. Wang B, Luo X, Wu M, et al. Identifying subtypes of long COVID: a systematic review. EClinicalMedicine. 2025;91:103705. doi:10.1016/j.eclinm.2025.103705

6. Wiegand RE, Chickery S, Yang DH, et al. Interim estimated effectiveness of 2025-2026 COVID-19 vaccines in adults using a test-negative design. JAMA Netw Open. 2026;9(6):e2625152. doi:10.1001/jamanetworkopen.2026.25152

7. Green R, Marjenberg Z, Lip GYH, et al. A systematic review and meta-analysis of the impact of vaccination on prevention of long COVID. Nat Commun. 2025;16(1):10326. doi:10.1038/s41467-025-65302-0

8. Faghy MA, Wüst RCI, Altmann DM, et al. Current status and future perspectives on the mechanistic and pathophysiological understanding of long COVID. Commun Med (Lond). 2026;6(1):255. doi:10.1038/s43856-025-01300-z