A clinical case definition of post-COVID-19 condition by a Delphi consensus

Abstract

People with COVID-19 might have sustained postinfection sequelae. Known by a variety of names, including long COVID or long-haul COVID, and listed in the ICD-10 classification as post-COVID-19 condition since September, 2020, this occurrence is variable in its expression and its impact. The absence of a globally standardised and agreed-upon definition hampers progress in characterisation of its epidemiology and the development of candidate treatments. In a WHO-led Delphi process, we engaged with an international panel of 265 patients, clinicians, researchers, and WHO staff to develop a consensus definition for this condition. 14 domains and 45 items were evaluated in two rounds of the Delphi process to create a final consensus definition for adults: post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction, and generally have an impact on everyday functioning. Symptoms might be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms might also fluctuate or relapse over time. A separate definition might be applicable for children. Although the consensus definition is likely to change as knowledge increases, this common framework provides a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy.

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“…The ability to detect anatomical sites of SARS-CoV-2 infection will facilitate our understanding of COVID-19 disease severity and the mechanism of comorbidities in the development of pathology. It could be especially useful in understanding long-COVID and its underlying causes 33,34 . This pilot study is a key step in the clinical development of this PET Further validation of the PET/CT probe's ability to identify areas of infection at sites other than the lungs and its utility in understanding COVID-19 pathogenesis was the revelation of a highly reproducible infection of the MGT.…”

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“…Symptoms might also fluctuate or relapse over time. A separate definition might be applicable for children" [40].…”

Eye Movement Alterations in Post-COVID-19 Condition: A Proof-of-Concept Study

“…We are now seeing that many COVID-19 survivors might have sustained postinfection sequelae, including fatigue, shortness of breath, and cognitive dysfunction, among others, which generally have an impact on everyday functioning [31]. These sequelae occur in patients with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.…”

“…These sequelae occur in patients with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset, with symptoms that last for at least two months and cannot be explained by an alternative diagnosis. Known by a variety of names, including long COVID or long-haul COVID, are listed in the ICD-10 classification as post-COVID-19 condition [31].…”