A general definition of long COVID established last week through the National Academies of Sciences, Engineering and Medicine (NASEM), at the request of the U. S. government.
The consensus definition of NASEM is as follows: “Long COVID (LC) is a chronic infection-associated disease (IACC) that after SARS-CoV-2 infection is maintained for at least 3 months as continuous, recurrent, remitting, or progressive disease. . A condition that affects one or more organ systems.
The definition, released last week, cites a family pulse survey conducted by the U. S. Census Bureau. A study by the U. S. Department of Health and the National Center for Health Statistics, which showed that, from March 5 to April 1 of this year, only about 18% of adults in the U. S. were vaccinated. U. S. experienced long COVID, and only about 7% are experiencing it lately.
The Centers for Disease Control and Prevention (CDC) says the most common symptoms reported by people with long COVID are:
The CDC has accepted the NASEM definition, but, as Dr. David Cutler, a board-certified family physician at Providence Saint John’s Health Center in Santa Monica, California, told Medical News Today, there is most likely still confusion about testing, diagnosis and treatment.
According to Cutler:
“The names ‘long COVID,’ ‘long COVID,’ or [post-acute COVID syndrome’] have now been classified as ‘long COVID,’ and while previous definitions varied depending on whether or not COVID infection preceded long symptoms, or symptoms were expected to last 2, 3, or 6 months, or whether shortness of breath, mental confusion or exertional fatigue were components of the syndrome, now the definition is clearer. Since there is no undeniable diagnostic test, there is likely some controversy to persist about exactly who has this condition.
Steve Allder, MD, a neurologist representing Re:Cognition Health, told MNT that the consensus definition would generate “frustration” everywhere, in part because creating a blanket definition for a disease with so many other reports and symptoms is so complicated.
“It is complex, it is a multiple formula; the existing formula was not adequate to deal with this kind of challenge before [the COVID-19 pandemic]. Since [the COVID-19 pandemic], there’s a massive preference for ‘get out of COVID,'” Allder told us. “There is no undeniable proof, mandatory investigations are expensive. “
“Since there is no cure for long COVID, the most vital remedy remains peace of mind,” Cutler said.
“Patients will be given the opportunity to communicate their symptoms to a receptive physician, thoroughly evaluated for other conditions, the diagnosis of long COVID will be approved in particular, and patients will be informed of the outcome, sometimes favorable. “long-term diagnosis and sufficiently good follow-up,” he advised.
Allder also believes that reducing a variety of symptoms to a single direct cause, based on the patient’s own reports, can be simply problematic.
“The main conflicts arise from the fact that existing definitions are mainly based on the presence of subjective symptoms self-reported by the patient. In my experience, medical professionals are very skeptical of this approach. This is especially true when the number of symptoms imaginable is high,” Allder said.
“There is a massive dispute [around this issue]. Some of this data is in the public domain, in magazines or in interviews conducted through doctors. But there’s a lot more to do when patients meet with doctors in the office. My non-public experience “has been [that] most patients get a lot of skepticism from the medical career about long COVID,” he told us.
Speaking about how COVID is affecting people lately, Allder noted that “[i]n a general disaster. “
“From my point of view, caring for patients is a genuine challenge. This is devastating the lives of other young people and their families. But as the clinical challenge overwhelms existing systems already overburdened or expensive, medicine and doctors have fallen short of the task. Face the challenge. It’s a lose-lose situation,” he told us.
Cutler described the already existing difficulty of diagnosing a disease with up to two hundred symptoms, but he told us that NASEM’s consensus definition is unlikely to simplify things.
“When it comes to fatigue, a progressive training program until symptoms worsen turns out to be best. And since there are no diagnostic symptoms, physical results or laboratory confirmation, the war of words over who has the disease will persist,” Cutler said.
“In addition, controversy persists over how to best manage symptoms related to long COVID. And there is a war of words about when to affirm that the situation is resolved,” he said.
In addition, “further debates persist about whether vaccines can contribute to the emergence of COVID cases in the long term,” he said, noting that this is most likely.
“Some studies recommend that Paxlovid reduces the occurrence of long COVID, while other studies fail to verify this result. And a recent study showed a lower occurrence of long COVID in obese patients taking the diabetes drug metformin. But there is no data on the effect of this drug on patients who have this long-term threat of COVID,” Cutler warned, recommending that it remains complicated to provide personalized care while there is still a lot of conflicting data about the disease. .
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