Postacute Sequelae of SARS-CoV-2 Infection—Reply

Treatable traits for long COVID

“…In North America, the National Institute of Health (NIH) utilizes an umbrella term of ‘post COVID conditions’ that includes the variety of health conditions that occur beyond the first 28 days (the acute illness), their definition, therefore, states that symptoms should be present for at least 4 weeks 15 . Another widely used term in research is post‐acute sequelae of COVID‐19 or SARS‐CoV‐2 infection (PASC), 11,16 which is typically defined by sequelae that persist for ≥28–30 days following initial onset; however, the definition is inconsistent across research studies. For this review, as it was developed by people with lived experience, 1,2 and is widely recognized across diverse audiences including the general public, we have used the term long COVID to collectively refer to definitions by the WHO, NICE and Australian Clinical Evidence Taskforce with the common time point of at least 12 weeks from acute COVID‐19 onset.…”

“…The number of people living with long COVID is still debated. Differences in COVID‐19 case definition (e.g., 4 vs. 12 weeks post COVID‐19 onset), acute COVID‐19 severity and variant and vaccination status may all influence prevalence estimates 16–21 . The presence of symptoms following COVID‐19 may also be due to non‐COVID‐19 related factors, which should be accounted for 5,22–24 .…”

“…The presence of symptoms following COVID‐19 may also be due to non‐COVID‐19 related factors, which should be accounted for 5,22–24 . This has been done by comparing the presence of symptoms in individuals prior to and following COVID‐19 or in COVID‐19 positive and negative cohorts matched for demographic and clinical factors 16,22 . Following this latter approach, current estimates suggest around 7%–13% of people who have had COVID‐19 will experience long COVID; 5,23,25 incidence of long COVID may be higher, at around 20%–30%, in those who were hospitalized during the acute phase 7,16,26 .…”

“…This has been done by comparing the presence of symptoms in individuals prior to and following COVID‐19 or in COVID‐19 positive and negative cohorts matched for demographic and clinical factors 16,22 . Following this latter approach, current estimates suggest around 7%–13% of people who have had COVID‐19 will experience long COVID; 5,23,25 incidence of long COVID may be higher, at around 20%–30%, in those who were hospitalized during the acute phase 7,16,26 . While people of all ages and acute COVID‐19 disease severities may develop long COVID, some risk factors have been identified: female sex, non‐white ethnicity, socioeconomic deprivation, smoking history (former or current), obesity, pre‐existing medical conditions and being unvaccinated against COVID‐19 prior to first SARS‐CoV‐2 infection 7,17,21,27–30 …”

“…The clinical syndrome of long COVID is complex and typically includes multiple symptoms that cross organ systems and fluctuate over time 7,23,26,27,30 . Emerging evidence also suggests there may be distinct long COVID symptom clusters or phenotypes, with the presence and severity of long COVID symptoms manifesting differently in different people and contexts 7,16,25,27,30 . Whilst over 200 symptoms have been described, there are some symptoms that occur more frequently than others and appear to cause the most morbidity and disability 7,11,23,25,26,30 .…”