- A new consensus definition of long-term COVID was established by the National Academies of Sciences, Engineering, and Medicine.
- The definition is 'an infection-associated chronic condition (IACC) that arises following SARS-CoV-2 infection and exists for at least 3 months as a persistent, relapsing and remitting, or progressive disease state that affects one or more organ systems.,
- However, some medical professionals say controversy is likely to continue within the medical community about a disease with so many different symptoms.
At the request of the United States government, a broad definition for long-term COVID was established by the National Academies of Sciences, Engineering, and Medicine (NASEM) last week.
The NASEM consensus definition is: “Long COVID (LC) is an infection-related chronic condition (IACC) that occurs following SARS-CoV-2 infection and exists for at least 3 months as a persistent, relapsing and remitting, or progressive disease state that affects one or more organ systems.”
The definition published last week cites one
The Centers for Disease Control and Prevention (CDC) says
- Tiredness
- Difficulty in breathing
- cough
- Joint pain
- Pain in chest
- brain fog, in which they have more difficulty thinking clearly and concentrating
- Depression
- Muscle pain
- Headache
- fever that comes and goes
- Increased heart rate, or feeling like your heart is beating fast.
The CDC has accepted the NASEM definition, but, as David Cutler, M.D., a board-certified family medicine physician at Providence Saint John's Health Center in Santa Monica, California, points out, Medical News Today There is still confusion about testing, diagnosis and treatment.
According to Cutler:
“'Long Covid' or 'Long-haul Covid' or [‘post-acute COVID syndrome’] All are now labelled 'long Covid'. And while previous definitions depended on whether symptoms persisted long after the diagnosed Covid infection, or required symptoms to persist for 2, 3 or 6 months, or required shortness of breath, brain fog or exertional fatigue to be part of the syndrome, the definition has now been clarified. But, as no simple diagnostic test exists, it is likely that there will remain some controversy about who suffers from the condition.”
Steve Elder, M.D., consulting neurologist at re:cognition Health, explains MNT A consensus definition will usually lead to “frustration” on all sides, as it is too complex to create a common definition for a disease with so many different experiences and symptoms.
“It's complex, it's really multi-system; the current system was already not well-suited to managing this type of problem.” [the COVID-19 pandemic]. since [the COVID-19 pandemic]“There is a huge desire to ‘move on’ from COVID,” Alder told us. “There is no simple test; the tests needed are expensive.”
“Since there is no cure for long COVID, the most important treatment is reassurance,” Cutler said.
“Patients should be given the opportunity to present their symptoms to a receptive clinician, be thoroughly assessed to rule out other conditions, then be specifically supported with a diagnosis of Long Covid, [then] “Patients should be informed of the generally favorable long-term prognosis, and adequate follow-up should be provided,” they advised.
Alder also believed that narrowing a range of symptoms down to a direct cause, often based on the patient's own statements, could be problematic.
“The main controversies arise from the fact that current definitions rely primarily on the presence of subjective symptoms reported by the patient himself. In my experience, the medical profession is highly skeptical of this approach. This is especially true when the number of possible symptoms is high,” Alder said.
“There is a huge controversy [around this topic]Some of this is in the public domain, in journals or in interviews given by doctors. But much more comes to light when patients meet doctors during consultations. My personal experience has been [that] “Most patients are very skeptical about long COVID from the medical profession,” he told us.
Speaking about how long COVID currently affects individuals, Elder said that “[i]This is a complete mess.”
“From my perspective of seeing patients, this is a real problem. It devastates the lives of young people and their families. But, because the clinical problem further strains already strained or expensive prescribing systems, medicine and clinicians are not able to meet this challenge. It's a lose-lose situation,” he told us.
Cutler described the difficulty already present in diagnosing a disease with up to 200 symptoms, but told us that NASEM's consensus definition is unlikely to simplify things.
“In the case of fatigue, a program of gradual exercise appears to be best to prevent worsening of symptoms. And since there is no single diagnostic symptom, physical finding or laboratory confirmation, there will continue to be disagreement about who has this condition,” Cutler said.
“In addition, there remains controversy over how to best manage the many symptoms associated with long COVID. And there is also disagreement over when the condition should be declared resolved,” he said.
moreover, “[f]“There is further debate as to whether vaccines reduce cases of long-haul Covid,” he said, though he added that it is most likely that they do.
,