We Wont Solve Long COVID Until We Decide What It Is

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Is a slow recovery from COVID-19 the lingering effects of a bad infection or the start of a new syndrome? • https://www.medscape.com/viewarticle/... • -- TRANSCRIPT -- • Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson of the Yale School of Medicine. • I want to help people suffering from long COVID as much as anyone. But we have a real problem. In brief, we are being too inclusive. The first thing you learn, when you start studying the epidemiology of diseases, is that you need a good case definition. And our case definition for long COVID sucks. Just last week, the National Academies of Sciences, Engineering, and Medicine (NASEM) issued a definition of long COVID with the aim of improving consistency, documentation and treatment. Good news, right? Here's the definition: Long COVID is an infection-associated chronic condition 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. • This is not helpful. The symptoms can be in any organ system, can be continuous or relapsing and remitting. Basically, if you've had COVID — and essentially all of us have by now — and you have any symptom, even one that comes and goes, 3 months after that, it's long COVID. They don't even specify that it has to be a new symptom. • I'm not saying that long COVID doesn't exist. I'm not saying it isn't weird or that it can't present in diverse ways. But a case definition like this hinders our ability to figure out exactly what is going on and to identify good treatments. It mixes people with real long COVID with a ton of other people, diluting our power to do science on the condition. And I have sort of a case study in this problem today, based on a paper getting a lot of press suggesting that 1 out of every 5 people have long COVID. • We are talking about this study, Epidemiologic Features of Recovery From SARS-CoV-2 Infection, appearing in JAMA Network Open this week. While I think the idea is important, the study really highlights why it can be so hard to study long COVID. • As part of efforts to understand long COVID, the National Institutes of Health (NIH) leveraged 14 of its ongoing cohort studies. The NIH has multiple longitudinal cohort studies that follow various groups of people over time. You may have heard of the REGARDS study, for example, which focuses on cardiovascular risks to people living in the southern United States. Or the ARIC study, which followed adults in four communities across the United States for the development of heart disease. All 14 of the cohorts in this study are long-running projects with ongoing data collection. So, it was not a huge lift to add some questions to the yearly surveys and studies the participants were already getting. • Transcript in its entirety can be found by clicking here: • https://www.medscape.com/viewarticle/...

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