Long Covid Defined Save

The National Academy of Medicine and New England Journal of Medicine have published a comprehensive definition of "long COVID".

While COVID-19 has infected over 7 million worldwide, it is estimated that 7% of adults (and >1% of children) or 15 to 20 million Americans have developed long COVID, a chronic condition with systemic and often disabling symptoms. 

To better address this complication the Office of the Department of Health and Human Services commissioned the National Academies of Sciences, Engineering, and Medicine (NASEM) to develope an improved definition. This process was complicated by considerable overlap with other similar conditions and the occurrence of chronic conditions following infections (e.g., myalgic encephalomyelitis–chronic fatigue syndrome, post-treatment Lyme disease, and multiple sclerosis, etc.). 

A multiphase process involving stakeholders, researchers and patients resulted in a three-part definition of long Covid: 1). The 2024 NASEM Long COVID definition; 2) core description of characteristic symptoms and associated diagnosable conditions, and 3) seven important features. These are reviewed belowo:

1. 2024 NASEM Long Covid Definition: Long Covid is an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.
2. Symptoms & Diagnoses: dyspnea, cough, fatigue, postexertional malaise, difficulty concentrating, memory changes, recurring headache, lightheadedness, fast heart rate, sleep disturbance, problems with taste or smell, bloating, constipation, and diarrhea. 
   • Additionally it has been associated with the following diagnoses: ILD and hypoxemia, cardiovascular disease and arrhythmias, cognitive impairment, mood disorders, anxiety, migraine, stroke, blood clots, chronic kidney disease, postural orthostatic tachycardia syndrome and other forms of dysautonomia, myalgic encephalomyelitis–chronic fatigue syndrome, mast-cell activation syndrome, fibromyalgia, connective-tissue diseases, hyperlipidemia, diabetes, and autoimmune disorders such as lupus, rheumatoid arthritis, and Sjögren’s syndrome.
3. Seven Important Features:
   • It can follow asymptomatic, mild, or severe SARS-CoV-2 infection. 
   •  It can be continuous from acute SARS-CoV-2 infection or have a delayed onset for weeks or months after even full recovery .
   • It can affect children or adults.
   • It can exacerbate preexisting health conditions or present as new conditions.
   • It can range from mild to severe and can resolve over a period of months or can persist for months or years.
   • It can be diagnosed on clinical grounds (there is no test or biomarker)
   • It can impair patients’ ability to work, attend school, take care of family, and care for themselves, resulting in profound emotional and physical effects on the patients, their families, and caregivers.