The National Academies of Sciences, Engineering, and Medicine (NASEM) recently established a new consensus definition for long COVID, aiming to provide clearer guidelines for diagnosis and treatment. This definition, requested by the U.S. government, describes long COVID as an infection-associated chronic condition (IACC) that occurs after SARS-CoV-2 infection and persists for at least three months, affecting one or more organ systems.
Understanding long COVID
According to the Centers for Disease Control and Prevention (CDC), nearly 18% of adults in the U.S. have experienced long COVID, with almost 7% currently dealing with its symptoms. Common symptoms include:
- Fatigue
- Shortness of breath
- Cough
- Joint pain
- Chest pain
- Brain fog
- Depression
- Muscle pain
- Headache
- Fever
- Heart palpitations
Medical community’s response
Despite the new definition, some medical professionals believe disputes within the medical community will persist. Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center, mentioned that the lack of a simple diagnostic test means controversy will likely continue regarding who suffers from the condition.
Dr. Steve Allder, a consultant neurologist at Re:Cognition Health, expressed concerns that the consensus definition might lead to frustration. He noted that the complexity and multi-system nature of long COVID make it difficult to manage within the current health care system.
Treatment and management
Dr. Cutler emphasized that reassurance remains the most important treatment for long COVID. Patients need to present their symptoms to a receptive physician, be thoroughly evaluated to exclude other conditions, and be informed of the generally favorable long-term prognosis. Adequate follow-up is also crucial.
However, Dr. Allder pointed out that relying on patient self-reported symptoms can be problematic, as the medical profession is often skeptical of this approach. The high number of possible symptoms adds to the complexity.
Ongoing challenges
Long COVID continues to affect individuals, particularly young people and their families, in devastating ways. Dr. Cutler noted that the NASEM consensus definition is unlikely to simplify the diagnosis and management of a disease with up to 200 symptoms. There is also ongoing debate about the best ways to manage these symptoms and when to declare the condition resolved.
Moreover, there is still uncertainty about whether vaccines reduce the incidence of long COVID. Some studies suggest that treatments like Paxlovid and metformin may reduce the incidence, but conflicting information makes it difficult to provide personalized care.
As the medical community grapples with the complexities of long COVID, the new consensus definition is a step towards clarity, but work remains to improve diagnosis and treatment.
