A new and broadly inclusive definition of long COVID has been developed from the National Academies of Sciences, Engineering, and Medicine (NASEM) with the goal of achieving greater consistency, documentation, and treatment for adults and children.
According to the NASEM 2024 definition of long COVID of June 11, 2024, “long COVID is a chronic infection-related illness that occurs after SARS-CoV-2 infection and is maintained for at least 3 months as an ongoing, recurrent, and remitting disease. . , or a progressive disease that affects one or more organ systems.
People with long COVID would possibly experience one or more of a long list of symptoms, such as shortness of breath, immediate heartbeat, excessive fatigue, post-exertional malaise, or sleep disturbances, as well as one or more diagnosable conditions, adding interstitial. lung disease, arrhythmias, postural orthostatic tachycardia syndrome (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), diabetes, or autoimmune disorders. This condition can exacerbate pre-existing fitness disorders or seem new.
The definition does not require laboratory confirmation or other evidence of initial infection. Long COVID can attach to a SARS-CoV-2 infection of any severity, adding asymptomatic infections, whether they were first identified or not.
Several definitions and terms for long COVID had already been proposed, adding those from the World Health Organization (WHO) and the U. S. Centers for Disease Control and Prevention. There was no unusual definition or terminology in the US, but no unusual definition or terminology had been established.
The new definition was developed at the request of the Strategic Preparedness and Response Administration and the Office of the Assistant Secretary for Health (OASH). It was written through a multi-stakeholder organization convened through NASEM, which seeks to have the new definition universally followed. through the federal government, clinical societies and associations, public fitness professionals, doctors, payers, the pharmaceutical industry, and all those who use the term long COVID.
Recent surveys indicate that about 7% of Americans have experienced or are experiencing long COVID. “That’s millions of people,” panel chairman Harvey V told Medscape Medical News. Fineberg, MD, president of the Gordon and Betty Moore Foundation.
The new definition “does not eliminate the challenge of clinical judgment . . . But we believe that this definition has the real advantage of generating in the physician’s brain the true probability, in the current environment of prevalence of this virus, that the symptoms of a patient presenting are genuine and perhaps similar to an expression of long COVID,” Fineberg noted.
One of the differences between this new definition and previous ones, such as the WHO’s, he said, is that “they speak of a diagnosis of exclusion. “One of the problems with our definition is that other diagnosable situations such as ME/CFS or POTS would possibly be on the list. They are not alternatives. In fact, they are an expression of long COVID.
In fact, the NASEM report also introduces the term chronic infection-related disease (IACC). This is important, Fineberg said, “because this is the largest circle of relatives of pathologies of which long COVID is a component. This emphasizes dating between long COVID and other pathologies that can arise from a variety of infections. We have also followed the term ‘pathological state’ to convey the severity and truth of this condition in the lives of patients. ”
In an article provided to Medscape Medical News, Lucinda Bateman, MD, and Brayden Yellman, MD, comedical administrators at the Bateman-Horne Center in Salt Lake City, said that “describing long COVID as an IACC. . . Not only does it meet the needs of NASEM. aim to enable physicians, researchers, and public health officials to meaningfully identify and care for all other people suffering from illness or disability as a result of SARS-CoV-2 infection, but it also makes a direct comparison with other known ones. IACCs (such as ME/CFS, Lyme aftertreatment, POTS) that have affected many other people for decades. “
Fineberg highlighted another vital facet of the NASEM report: “Our definition includes a detail on equity, explaining that long COVID can have effects on anyone, young and old, other races, other ages, other sexes, other genders, other orientations, other socioeconomic conditions. . . This does not mean that everyone is under the same threat. There are threat factors, but the vital point is the universal nature of this condition.
Two long-term COVID systems clinical administrators contacted through Medscape Medical News welcomed the new definition. Zijian Chen, MD, director of the Center for Post-COVID Care at Mount Sinai, New York, said it’s “very similar to the definition they’ve been for our clinical practice since 2020. It is very important that the broad definition helps to be included. The inclusion of young people is also vital, as less emphasis is regularly placed on young people, as they tend to have a lower frequency of illness. . . Creating a unified definition facilitates clinical practice and research. “
Nisha Viswanathan, MD, director of the Long COVID Program at the University of California, Los Angeles, said, “I think they deliberately left a broad scope so that the doctor wouldn’t necessarily use the definition to exclude individuals, but perhaps use more. Clinical gestalt to aid in this diagnosis. . . I believe this definition provides clarity to physical care providers on what exactly would be included under the heading of long-term COVID diagnosis.
Viswanathan also said he hopes this definition will help patients make their case when filing disability claims. “Because COVID for a long time did not yet have a well-developed definition, it was very straightforward for disability providers to reject claims for patients who continue to have symptoms. . . . I think it can eventually help our patients in their attempt to be able to have symptoms. The ability to take care of themselves when they are disabled enough that they cannot work.
The report predicts that the definition “will evolve as new evidence emerges and the duration of COVID matures. “The editorial board asks for a review in “no more than 3 years”. Factors that would trigger a reassessment may come with advances in testing methods, the discovery of medical points and/or biomarkers that distinguish long COVID from other diseases, and new treatments.
Meanwhile, Fineberg told Medscape Medical News, “If this definition adds up to the COVID patient’s preparation, awareness, openness, and reaction, it will have done its job. ”
Fineberg, Bateman, Yellman, Viswanathan and Chen have not commented.
Miriam E. Tucker is a freelance journalist based in the Washington, D. C. area. She is a regular contributor to Medscape and has been featured in other works in the Washington Post, NPR’s Shots blog, and Diatribe. It’s on X (formerly Twitter). ) @MiriamETucker.
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