Post by Nadica (She/Her) on Aug 23, 2024 0:09:32 GMT
Long COVID Clinical Evaluation, Research and Impact on Society: A Global Expert Consensus - Preprint Posted Aug 21, 2024
Abstract
Background: Long COVID is a complex, heterogeneous syndrome affecting at least one hundred million people globally. The World Health Organisation (WHO) lists ‘confirmed’ cases of COVID-19 at 775 million1 . This number is likely much greater due to the limitations of testing and very limited surveillance2 . Following acute COVID-19, the risk of developing symptoms that last beyond the initial illness, is estimated to be 15% per individual per infection2 . There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed. Disseminating information to physicians and policy makers is essential to address this escalating global health crisis.
Methods: A 3-round modified Delphi consensus methodology was distributed internationally to 179 healthcare professionals, researchers, and persons with lived experience of Long COVID located in 28 countries across the world. Statements were combined into specific areas: definition, diagnosis, treatment, research, and society. A 5-point Likert Scale was used. A supermajority (≥67% combined agreement – strongly agree and agree) was used for consensus.
Findings: The strongest consensus areas were in diagnosis and clinical assessment with 1 unanimous statement, 19 A-level (89-99%), 13 B-level (7888%) and 3 C-level (67-77%) statements, general research with 24 A-level, 13 Blevel and 6 C-level statements, research on children and young people with15 A-level and 6 B-level statements, and funding, economic and societal issues with 4 A-level, 3 B-level, and 1 C level statements. Organ or body damage (1 A-level, 8 B-level and 1 C-level) and Long COVID and vaccines (2 A-level, 7 B-level, and 1 C-level) require more research before we can reach a broad consensus. Not surprisingly, there was less congruence on treatment (9 A-level, 13 B-level and 15 C-level statements) and evaluation of treatment (2 A-level, 5 B-level and 2 C-level statements) as clinicians around the world have adopted their own practices in the absence of clear guidelines or a strong evidence-base.
Interpretation: This reinforces the need for translational research and large-scale treatment trials. Research on organ or body damage and Long COVID and vaccines were also areas where it was difficult to find a high level of consensus, but those statements that did reach consensus are significant.
Abstract
Background: Long COVID is a complex, heterogeneous syndrome affecting at least one hundred million people globally. The World Health Organisation (WHO) lists ‘confirmed’ cases of COVID-19 at 775 million1 . This number is likely much greater due to the limitations of testing and very limited surveillance2 . Following acute COVID-19, the risk of developing symptoms that last beyond the initial illness, is estimated to be 15% per individual per infection2 . There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed. Disseminating information to physicians and policy makers is essential to address this escalating global health crisis.
Methods: A 3-round modified Delphi consensus methodology was distributed internationally to 179 healthcare professionals, researchers, and persons with lived experience of Long COVID located in 28 countries across the world. Statements were combined into specific areas: definition, diagnosis, treatment, research, and society. A 5-point Likert Scale was used. A supermajority (≥67% combined agreement – strongly agree and agree) was used for consensus.
Findings: The strongest consensus areas were in diagnosis and clinical assessment with 1 unanimous statement, 19 A-level (89-99%), 13 B-level (7888%) and 3 C-level (67-77%) statements, general research with 24 A-level, 13 Blevel and 6 C-level statements, research on children and young people with15 A-level and 6 B-level statements, and funding, economic and societal issues with 4 A-level, 3 B-level, and 1 C level statements. Organ or body damage (1 A-level, 8 B-level and 1 C-level) and Long COVID and vaccines (2 A-level, 7 B-level, and 1 C-level) require more research before we can reach a broad consensus. Not surprisingly, there was less congruence on treatment (9 A-level, 13 B-level and 15 C-level statements) and evaluation of treatment (2 A-level, 5 B-level and 2 C-level statements) as clinicians around the world have adopted their own practices in the absence of clear guidelines or a strong evidence-base.
Interpretation: This reinforces the need for translational research and large-scale treatment trials. Research on organ or body damage and Long COVID and vaccines were also areas where it was difficult to find a high level of consensus, but those statements that did reach consensus are significant.