ISLAMABAD, June 20 (Online): A new consensus definition of long COVID was established by the National Academies of Sciences, Engineering, and Medicine.
\nThe definition is \u2018an infection-associated chronic condition (IACC) 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.\u2018
\nHowever, some medical professionals say that disputes within the medical community about a disease with so many different symptoms will likely persist.
\nAn umbrella definition for long COVID was established last week by the National Academies of Sciences, Engineering, and Medicine (NASEM), as requested by the United States government.<\/p>\n
The NASEM consensus definition is: \u201cLong COVID (LC) is an infection-associated chronic condition (IACC) 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.\u201d<\/p>\n
The definition, published last week, cites a U.S. Census Bureau and National Center for Health Statistics Household Pulse SurveyTrusted Source, which showed that, as of March 5 to April 1 of this year, nearly 18% of adults in the U.S. have experienced long COVID, and nearly 7% are currently experiencing it.<\/p>\n
The Centers for Disease Control and Prevention (CDC) say that the symptomsTrusted Source most commonly reported for people with long COVID are:<\/p>\n
fatigue
\nshortness of breath
\ncough
\njoint pain
\nchest pain
\nbrain fog, wherein they find it more difficult to think clearly and focus
\ndepression
\nmuscle pain
\nheadache
\nfever, which may come and go
\nheart palpitations, or a feeling of the heart pounding.<\/p>\n
How helpful is an umbrella-definition of long COVID?
\nThe CDC has accepted the NASEM definition, but, as David Cutler, MD, board certified family medicine physician at Providence Saint John\u2019s Health Center in Santa Monica, CA, told Medical News Today that there is still likely to be confusion about testing, diagnosis, and treatment.<\/p>\n
According to Cutler:<\/p>\n
\u201cThe names \u2018long COVID,\u2019 or \u2018long-haul COVID,\u2019 or [\u2018post-acute COVID syndrome\u2019] have now all been labeled \u2018long COVID.\u2019 And while previous definitions varied depending on whether or not a diagnosed COVID infection preceded the prolonged symptoms, or the symptoms needed to last for 2, 3, or 6 months, or whether shortness of breath, brain fog or exertional fatigue needed to be part of the syndrome, now the definition has been made clearer. But, since no simple diagnostic test exists, it is likely that some controversy will persist regarding precisely who suffers from this condition.\u201d<\/p>\n
Steve Allder, MD, a consultant neurologist at Re:Cognition Health, told MNT that the consensus definition would generally lead to \u201cfrustration\u201d all around, in part because creating an umbrella-definition for a disease with so many different experiences and symptoms is very complicated.<\/p>\n
\u201cIt\u2019s complex, it\u2019s truly multi-system; the current system was poorly suited to manage this type of problem prior to [the COVID-19 pandemic]. Since [the COVID-19 pandemic], there is a huge desire to \u2018move on\u2019 from COVID,\u201d Allder told us. \u201cThere is no simple test, the investigations required are expensive.\u201d<\/p>\n
Long COVID patients still face scepticism from doctors
\n\u201cSince there is no cure for long COVID, the most important treatment remains reassurance,\u201d Cutler opined.<\/p>\n
\u201cPatients must be allowed the opportunity to present their symptoms to a receptive physician, they must be thoroughly evaluated to exclude other conditions, the diagnosis of long COVID should then be specifically endorsed, [then] patients need to be informed of the generally favorable long-term prognosis, and adequate follow-up provided,\u201d he advised.<\/p>\n
Allder also believed that narrowing a range of symptoms down to one direct cause, often based on a patient\u2019s own statements, can be problematic.<\/p>\n
\u201cMajor conflicts arise from the fact that current definitions rely mainly on the presence of patient self-reported subjective symptoms. In my experience, the medical profession is highly sceptical of this approach. This is especially true when the number of possible symptoms is high,\u201d Allder said.<\/p>\n
\u201cThere is huge dispute [around this topic]. Some of this is in the public domain, in journals or interviews given by clinicians. But there is far more on the coalface when patients encounter clinicians in consultations. My personal experience has been [that] most patients receive huge scepticism from the medical profession about long COVID,\u201d he told us.<\/p>\n
Will the unifying definition help improve long COVID care?
\nSpeaking of how long COVID currently affects individuals, Allder noted that \u201c[i]t is a total mess.\u201d<\/p>\n
\u201cFrom my perspective of seeing patients, it\u2019s a real problem. It devastates young people\u2019s \u2014 and their families\u2019 \u2014 lives. But, because the clinical problem overwhelms the already stretched or expensive prevailing systems, medicine and clinicians haven\u2019t been able to rise to the challenge. This is a lose-lose situation,\u201d he told us.<\/p>\n
Cutler described the already existing difficulty of diagnosing a disease with up to 200 symptoms, but told us that the NASEM consensus definition is unlikely to simplify things.<\/p>\n
\u201cRegarding fatigue, a program of graded exercise to avoid worsening symptoms seems to be best. And since there is no single diagnostic symptom, physical finding or laboratory confirmation, disagreement will persist regarding who has the condition,\u201d Cutler said.<\/p>\n
\u201cIn addition, there remains controversy over how to best manage the multiple symptoms associated with long COVID. And there is disagreement about when to declare the condition resolved,\u201d he noted.<\/p>\n
Moreover, \u201c[f]urther debate persists about whether vaccines reduce the incidence of long COVID,\u201c he pointed out, while noting that most likely they do.<\/p>\n
\u201c[S]ome studiesTrusted Source suggest that Paxlovid reduces the incidence of long COVID, while other studiesTrusted Source fail to confirm this finding. And a recent studyTrusted Source showed reduced incidence of long COVID in overweight patients who took the diabetes drug metformin. But there is no information on the effect of this drug on patients who lack this long COVID risk factor,\u201d cautioned Cutler, suggesting that it remains difficult to provide personalized care when there is still much conflicting information about the disease.<\/p>\n","protected":false},"excerpt":{"rendered":"
ISLAMABAD, June 20 (Online): A new consensus definition of long COVID was established by the National Academies of Sciences, Engineering, and Medicine. The definition is \u2018an infection-associated chronic condition (IACC) that occurs after SARS-CoV-2 infection and is present for at least 3 months as a […]<\/p>\n
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