Will a new ‘consensus definition’ help improve care?

person in black jacket shown seated and holing a bag on their lap, their face not visibleShare on Pinterest
Can a new umbrella-definition of long COVID help healthcare providers diagnose the condition and suggest better treatment avenues? Image credit: The Washington Post/Getty Images
  • A new consensus definition of long COVID was established by the National Academies of Sciences, Engineering, and Medicine.
  • The definition 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.
  • However, some medical professionals say that disputes within the medical community about a disease with so many different symptoms will likely persist.

An 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.

The NASEM consensus definition is: “Long 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.”

The definition, published last week, cites a U.S. Census Bureau and National Center for Health Statistics Household Pulse Survey, 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.

The Centers for Disease Control and Prevention (CDC) say that the symptoms most commonly reported for people with long COVID are:

  • fatigue
  • shortness of breath
  • cough
  • joint pain
  • chest pain
  • brain fog, wherein they find it more difficult to think clearly and focus
  • depression
  • muscle pain
  • headache
  • fever, which may come and go
  • heart palpitations, or a feeling of the heart pounding.

The CDC has accepted the NASEM definition, but, as David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told Medical News Today that there is still likely to be confusion about testing, diagnosis, and treatment.

According to Cutler:

“The names ‘long COVID,’ or ‘long-haul COVID,’ or [‘post-acute COVID syndrome’] have now all been labeled ‘long COVID.’ 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.”

Steve Allder, MD, a consultant neurologist at Re:Cognition Health, told MNT that the consensus definition would generally lead to “frustration” all around, in part because creating an umbrella-definition for a disease with so many different experiences and symptoms is very complicated.

“It’s complex, it’s 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 ‘move on’ from COVID,” Allder told us. “There is no simple test, the investigations required are expensive.”

“Since there is no cure for long COVID, the most important treatment remains reassurance,” Cutler opined.

“Patients 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,” he advised.

Allder also believed that narrowing a range of symptoms down to one direct cause, often based on a patient’s own statements, can be problematic.

“Major 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,” Allder said.

“There 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,” he told us.

Speaking of how long COVID currently affects individuals, Allder noted that “[i]t is a total mess.”

“From my perspective of seeing patients, it’s a real problem. It devastates young people’s — and their families’ — lives. But, because the clinical problem overwhelms the already stretched or expensive prevailing systems, medicine and clinicians haven’t been able to rise to the challenge. This is a lose-lose situation,” he told us.

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.

“Regarding 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,” Cutler said.

“In 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,” he noted.

Moreover, “[f]urther debate persists about whether vaccines reduce the incidence of long COVID,“ he pointed out, while noting that most likely they do.

[S]ome studies suggest that Paxlovid reduces the incidence of long COVID, while other studies fail to confirm this finding. And a recent study 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,” cautioned Cutler, suggesting that it remains difficult to provide personalized care when there is still much conflicting information about the disease.

Source link

Visited 1 times, 1 visit(s) today

Related Article

A military beret bearing the Armed Forces of the Democratic Republic of Congo (FARDC) insignia lies discarded alongside a pile of unspent cartridges near an abandoned, bullet-riddled military truck in Goma on January 31, 2025. The Rwandan-backed armed group M23 moved south as it closed in on a key military airport in DR Congo on January 31, 2025, a day after pledging to take the capital Kinshasa and as international criticism mounted. The group's capture of most of Goma, the capital of North Kivu province, earlier in the week was a dramatic escalation in a region that has seen decades of conflict involving multiple armed groups. (Photo by Tony KARUMBA / AFP)(AFP)

Rwanda does a Putin in Congo | World News

SOMETHING AWFUL is happening in Congo. A rebel group called M23 seized control of Goma, the biggest city in the east of the country, on January 27th, killing several UN peacekeepers and prompting hundreds of thousands of locals to flee. Hardly anyone outside central Africa knows who M23 are or why they are fighting. So

Image used for representational purpose.

Rupee plunges 45 paise to hit record low of 87.95 against U.S. dollar in early trade

Image used for representational purpose. | Photo Credit: Reuters The rupee depreciated 45 paise to hit a record low of 87.95 against the U.S. dollar in early trade on Monday (February 10, 2025) weighed down by the strength of the American currency in the overseas market and a negative trend in domestic equities. Forex traders

Have $6,000? These 3 Stocks Could Be Bargain Buys for 2025 and Beyond

Micron Technologies, Qualcomm, and Cisco Systems look cheap relative to their growth potential. Many tech stocks surged to record highs over the past year amid hopes for deeper interest rate cuts and an improved macroeconomic environment. But in this volatile bull market, it might seem tough to find bargains that are trading at reasonable valuations.

Singapore’s DBS surges to record on higher margins, capital return plans

By Yantoultra Ngui and Roushni Nair SINGAPORE (Reuters) -Shares of DBS soared to a record high on Monday after Singapore’s largest bank flagged an improvement in net interest income for 2025 and a dividend capital return plan, in line with a jump in fourth-quarter profit that met expectations. Southeast Asia’s largest bank by assets now

MN dog wins 'Most Valuable Puppy' at Puppy Bowl

MN dog wins ‘Most Valuable Puppy’ at Puppy Bowl

article Foxtrot from Pet Haven of MN (Animal Planet/Warner Bros. Discovery / Supplied) (FOX 9) – A Minnesota dog earned the top individual honor at the Puppy Bowl on Sunday. Puppy Bowl MVP What we know: Foxtrot, a Collie from Pet Haven of Minnesota, was named MVP (Most Valuable Puppy) of Puppy Bowl XXI on

Hong Kong police revealed the six fugitives for whom HK$1 million bounties had been offered in December. Carmen Lau is shown top left. Photo: Jelly Tse

Hong Kong national security police question 2 relatives of fugitive Carmen Lau

National security police have brought in two relatives of a Hong Kong fugitive to help with an ongoing investigation, the Post has learned. A source familiar with the case said officers invited a male and female relative of opposition figure Carmen Lau Ka-man, 29, a former Wong Tai Sin district councillor, to be questioned at

Celebrity Reactions to Winner of Game

The crowd at Super Bowl LIX was unsurprisingly filled with plenty of celebrity guests. There were the expected attendees, like Philadelphia Eagles superfan Bradley Cooper and Kansas City Chiefs fanatic Paul Rudd, along with Taylor Swift, Miles Teller and Pete Davidson. The Eagles led the Chiefs throughout Sunday night’s game before triumphing over the reigning

Kendrick Lamar's Super Bowl half-time show was one big tease

Kendrick Lamar’s Super Bowl half-time show was one big tease

Mark Savage Music Correspondent Reuters Kendrick Lamar is the first rapper to headline the Super Bowl as a solo act “I want to play their favourite song… but you know they love to sue,” said Kendrick Lamar, a couple of minutes into his Super Bowl half-time show. Everyone knew what he was referring to. Not

Why Doximity, Inc. (DOCS) Soared Last Week?

We recently published a list of 10 Firms That Soared Last Week. In this article, we are going to take a look at where Doximity, Inc. (NYSE:DOCS) stands against other firms that soared last week. Last week saw volatile trading in the stock market as investors scrambled to react from a series of positive and

Reduce The Risk Of Dementia And More: Expert Explains How To Protect Brain From Neurodegeneration

With ageing, neurodegenerative diseases like Alzheimer’s, Parkinson’s, and other types of dementia are one of the biggest threats to brain health. There is a genetic component to these diseases, but further research has shown that lifestyle can have a powerful influence on brain health. We spoke to Dr Avinash Kulkarni, Consultant Neurologist, Gleneagles BGS Hospital, Kengeri,

Ecuador election ends in a 'tie' prompting run-off in April

Ecuador election ends in a ‘tie’ prompting run-off in April

Ione Wells South America correspondent Reuters The campaign was dominated by the incumbent, Daniel Noboa’s hard-line approach to Ecuador’s violent drug gangs Ecuador’s presidential election will go to a second round after a closely contested first-round result failed to produce an outright winner. The electoral authorities called it a “technical tie” after the incumbent centre-right

HashKey Wins Hong Kong Approval to Offer Crypto Account Services to Professionals

HashKey Wins Hong Kong Approval to Offer Crypto Account Services to Professionals

HashKey has been granted approval to offer discretionary account management services for virtual assets (VA) to professional investors in Hong Kong. According to a blog post, Hong Kong’s Securities and Futures Commission (SFC) approved HashKey to manage tailored investment products, including spot crypto investments and derivatives under the existing type 9 license. This allows the

Brain health rests on heart health: Guidelines for lifestyle changes

Dementia is a growing global concern, affecting millions of individuals and their caregivers. With projections indicating that dementia cases will triple by 2050, the World Health Organization (WHO) has issued comprehensive guidelines emphasising the link between heart health and brain health. These recommendations focus on lifestyle changes that can significantly lower the risk of cognitive

0
Would love your thoughts, please comment.x
()
x