Long COVID: Difference between revisions

m (New citations)
mNo edit summary
Line 4: Line 4:


== Introduction ==
== Introduction ==
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease (COVID-19) <ref>https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it</ref>. The effects of COVID-19 have been characterised across different time points, defined as <ref name=":1">https://www.nice.org.uk/guidance/gid-ng10179/documents/final-scope</ref>:  
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease (COVID-19) <ref>https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it</ref>. The effects of COVID-19 have been characterised across different time points <ref name=":1">https://www.nice.org.uk/guidance/gid-ng10179/documents/final-scope</ref>:  
* Acute COVID-19 infection with signs and symptoms of COVID-19 for up to 4 weeks.
* Acute COVID-19 infection with signs and symptoms of COVID-19 for up to 4 weeks.
* Ongoing symptomatic COVID-19 with signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.
* Ongoing symptomatic COVID-19 with signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.
* Long term consequences of COVID-19 which usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body for more than 12 weeks.
* Long term consequences of COVID-19 which usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body for more than 12 weeks.


The long term sequelae of COVID-19 awaits consensus definition, and a variety of nomenclature has been used to describe the long term signs and symptoms of COVID-19. This includes the patient directed terms "Long Covid" <ref name=":0">https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/</ref><ref name=":2">https://www.sciencedirect.com/science/article/pii/S0277953620306456</ref><ref>https://www.nature.com/articles/d41586-020-02796-2</ref><ref>https://www.bmj.com/content/371/bmj.m4938</ref><ref>https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications</ref><ref>https://www.nature.com/articles/d41586-020-02796-2</ref>, "Long-Haul Covid" <ref name=":2" /><ref>https://n.neurology.org/content/95/13/559.long</ref> and "Long Haulers" <ref>https://www.nature.com/articles/d41586-020-02598-6</ref><ref>https://onlinelibrary.wiley.com/doi/10.1002/jmv.26624</ref>, plus other terms including "Post-COVID-19 syndrome" <ref name=":1" /><ref>https://openres.ersjournals.com/content/6/4/00542-2020</ref>, "Post-COVID Syndrome" <ref>https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/</ref>, "Post-Acute COVID-19" <ref>https://www.bmj.com/content/370/bmj.m3026</ref>, and "Post-Acute COVID-19 syndrome"<ref>https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/</ref>. For the purposes of consistency, this page will refer to the long term consequences of COVID-19 as "'''''Long Covid'''''" and to "'''''People Living with COVID-19'''''". We will refer to "Long Covid" because this term acknowledges that disease cause and course are as yet unknown, makes clear that “mild” COVID-19 is not necessarily mild, avoids “chronic,” “post” and “syndrome” that may delegitimise peoples experiences, draws attention to morbidity, and centres people with disability <ref name=":0" />. We will refer to "People Living with COVID-19" to align with existing person first language <ref>https://evidence.nihr.ac.uk/themedreview/living-with-covid19/</ref> and applying knowledge from other health care conditions with experiences of stigma <ref>https://www.nhivna.org/file/5dcbdcb83254e/BP-19-2.pdf</ref>.     
The long term sequelae of COVID-19 awaits consensus definition, and a variety of nomenclature has been used to describe the long term signs and symptoms of COVID-19. This includes the patient directed terms "Long Covid" <ref name=":0">https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/</ref><ref name=":2">https://www.sciencedirect.com/science/article/pii/S0277953620306456</ref><ref>https://www.nature.com/articles/d41586-020-02796-2</ref><ref name=":3">https://www.bmj.com/content/371/bmj.m4938</ref><ref>https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications</ref><ref>https://www.nature.com/articles/d41586-020-02796-2</ref>, "Long-Haul Covid" <ref name=":2" /><ref>https://n.neurology.org/content/95/13/559.long</ref> and "Long Haulers" <ref>https://www.nature.com/articles/d41586-020-02598-6</ref><ref>https://onlinelibrary.wiley.com/doi/10.1002/jmv.26624</ref>, plus other terms including "Post-COVID-19 syndrome" <ref name=":1" /><ref>https://openres.ersjournals.com/content/6/4/00542-2020</ref>, "Post-COVID Syndrome" <ref>https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/</ref>, "Post-Acute COVID-19" <ref>https://www.bmj.com/content/370/bmj.m3026</ref>, and "Post-Acute COVID-19 syndrome"<ref>https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/</ref>. For the purposes of consistency, this page will refer to the long term consequences of COVID-19 as "'''''Long Covid'''''" and to "'''''People Living with COVID-19'''''". We will refer to "Long Covid" because this term acknowledges that disease cause and course are as yet unknown, makes clear that “mild” COVID-19 is not necessarily mild, avoids “chronic,” “post” and “syndrome” that may delegitimise peoples experiences, draws attention to morbidity, and centres people with disability <ref name=":0" />. We will refer to "People Living with COVID-19" to align with existing person first language <ref>https://evidence.nihr.ac.uk/themedreview/living-with-covid19/</ref> and applying knowledge from other health care conditions with experiences of stigma <ref>https://www.nhivna.org/file/5dcbdcb83254e/BP-19-2.pdf</ref>.     


== What is Long Covid? ==
== What is Long Covid? ==
Long Covid has been preliminarily defined by The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners, as the presence of signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for 12-weeks or more and are not explained by an alternative diagnosis. This includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and "Post-COVID Syndrome" (12-weeks or more) <ref name=":4">https://www.nice.org.uk/guidance/ng188</ref>. Consensus has not yet been reached for a Long Covid definition <ref name=":3" /><ref name=":5">https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2.full.pdf</ref><ref>https://www.medrxiv.org/content/10.1101/2020.12.08.20246025v1</ref>.
== Long Covid Symptoms ==
Long Covid usually presents as clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body <ref name=":4" /><ref name=":5" /><ref>https://jamanetwork.com/journals/jama/fullarticle/2768351</ref><ref name=":6">https://patientresearchcovid19.com/research/report-1/</ref><ref>https://www.journalofinfection.com/article/S0163-4453(20)30762-3/fulltext</ref>. Long Covid can include a range of 205 different signs and symptoms across body systems including but not limited to: pulmonary, cardiovascular, gastrointestinal, reproductive, genitourinary, endocrine, renal, dermatologic, musculoskeletal, neurological, neuropsychiatric, immunological, ophthalmic, and audiological <ref name=":5" />.
The most common Long Covid symptom is fatigue <ref name=":5" /><ref>https://www.medrxiv.org/content/10.1101/2020.11.04.20226126v1</ref><ref>https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/late-sequelae.html</ref><ref>https://www.medrxiv.org/content/10.1101/2020.10.14.20212555v1</ref><ref>https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm</ref><ref>https://www.acpjournals.org/doi/10.7326/M20-5926</ref>. The most frequently reported Long Covid symptoms after 6 months include fatigue, post-exertion malaise, and cognitive dysfunction <ref name=":5" />. The multidimensional, episodic and often unpredictable nature of Long Covid has been described as "relapsing and remitting" <ref name=":6" />, whereby 86% of people with Long Covid report relapses over 7 months, with physical activity, stress, exercise and mental activity being the most common triggers of relapses <ref name=":5" />. The trajectory of Long Covid is heterogenous with some improving over time, some worsening and others unchanging, with many experiencing ongoing symptoms after 6 months <ref name=":5" />.


== Mechanism of Injury / Pathological Process  ==
== Mechanism of Injury / Pathological Process  ==

Revision as of 11:49, 2 January 2021

Original Editor - Darren Brown
Top Contributors - Darren Brown, Jess Bell, Olajumoke Ogunleye, Robin Tacchetti, Kim Jackson, Shwe Shwe U Marma, Tarina van der Stockt, Lucinda hampton, Candace Goh and Chelsea Mclene

Introduction[edit | edit source]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease (COVID-19) [1]. The effects of COVID-19 have been characterised across different time points [2]:

  • Acute COVID-19 infection with signs and symptoms of COVID-19 for up to 4 weeks.
  • Ongoing symptomatic COVID-19 with signs and symptoms of COVID-19 from 4 weeks up to 12 weeks.
  • Long term consequences of COVID-19 which usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body for more than 12 weeks.

The long term sequelae of COVID-19 awaits consensus definition, and a variety of nomenclature has been used to describe the long term signs and symptoms of COVID-19. This includes the patient directed terms "Long Covid" [3][4][5][6][7][8], "Long-Haul Covid" [4][9] and "Long Haulers" [10][11], plus other terms including "Post-COVID-19 syndrome" [2][12], "Post-COVID Syndrome" [13], "Post-Acute COVID-19" [14], and "Post-Acute COVID-19 syndrome"[15]. For the purposes of consistency, this page will refer to the long term consequences of COVID-19 as "Long Covid" and to "People Living with COVID-19". We will refer to "Long Covid" because this term acknowledges that disease cause and course are as yet unknown, makes clear that “mild” COVID-19 is not necessarily mild, avoids “chronic,” “post” and “syndrome” that may delegitimise peoples experiences, draws attention to morbidity, and centres people with disability [3]. We will refer to "People Living with COVID-19" to align with existing person first language [16] and applying knowledge from other health care conditions with experiences of stigma [17].

What is Long Covid?[edit | edit source]

Long Covid has been preliminarily defined by The National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners, as the presence of signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for 12-weeks or more and are not explained by an alternative diagnosis. This includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and "Post-COVID Syndrome" (12-weeks or more) [18]. Consensus has not yet been reached for a Long Covid definition [6][19][20].

Long Covid Symptoms[edit | edit source]

Long Covid usually presents as clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body [18][19][21][22][23]. Long Covid can include a range of 205 different signs and symptoms across body systems including but not limited to: pulmonary, cardiovascular, gastrointestinal, reproductive, genitourinary, endocrine, renal, dermatologic, musculoskeletal, neurological, neuropsychiatric, immunological, ophthalmic, and audiological [19].

The most common Long Covid symptom is fatigue [19][24][25][26][27][28]. The most frequently reported Long Covid symptoms after 6 months include fatigue, post-exertion malaise, and cognitive dysfunction [19]. The multidimensional, episodic and often unpredictable nature of Long Covid has been described as "relapsing and remitting" [22], whereby 86% of people with Long Covid report relapses over 7 months, with physical activity, stress, exercise and mental activity being the most common triggers of relapses [19]. The trajectory of Long Covid is heterogenous with some improving over time, some worsening and others unchanging, with many experiencing ongoing symptoms after 6 months [19].

Mechanism of Injury / Pathological Process[edit | edit source]

add text here relating to the mechanism of injury and/or pathology of the condition

Clinical Presentation[edit | edit source]

add text here relating to the clinical presentation of the condition

Diagnostic Procedures[edit | edit source]

add text here relating to diagnostic tests for the condition

Outcome Measures[edit | edit source]

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions[edit | edit source]

add text here relating to management approaches to the condition

Differential Diagnosis[edit | edit source]

add text here relating to the differential diagnosis of this condition

Resources[edit | edit source]

add appropriate resources here

References[edit | edit source]

  1. ↑ https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it
  2. ↑ 2.0 2.1 https://www.nice.org.uk/guidance/gid-ng10179/documents/final-scope
  3. ↑ 3.0 3.1 https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/
  4. ↑ 4.0 4.1 https://www.sciencedirect.com/science/article/pii/S0277953620306456
  5. ↑ https://www.nature.com/articles/d41586-020-02796-2
  6. ↑ 6.0 6.1 https://www.bmj.com/content/371/bmj.m4938
  7. ↑ https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications
  8. ↑ https://www.nature.com/articles/d41586-020-02796-2
  9. ↑ https://n.neurology.org/content/95/13/559.long
  10. ↑ https://www.nature.com/articles/d41586-020-02598-6
  11. ↑ https://onlinelibrary.wiley.com/doi/10.1002/jmv.26624
  12. ↑ https://openres.ersjournals.com/content/6/4/00542-2020
  13. ↑ https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/
  14. ↑ https://www.bmj.com/content/370/bmj.m3026
  15. ↑ https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/
  16. ↑ https://evidence.nihr.ac.uk/themedreview/living-with-covid19/
  17. ↑ https://www.nhivna.org/file/5dcbdcb83254e/BP-19-2.pdf
  18. ↑ 18.0 18.1 https://www.nice.org.uk/guidance/ng188
  19. ↑ 19.0 19.1 19.2 19.3 19.4 19.5 19.6 https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2.full.pdf
  20. ↑ https://www.medrxiv.org/content/10.1101/2020.12.08.20246025v1
  21. ↑ https://jamanetwork.com/journals/jama/fullarticle/2768351
  22. ↑ 22.0 22.1 https://patientresearchcovid19.com/research/report-1/
  23. ↑ https://www.journalofinfection.com/article/S0163-4453(20)30762-3/fulltext
  24. ↑ https://www.medrxiv.org/content/10.1101/2020.11.04.20226126v1
  25. ↑ https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/late-sequelae.html
  26. ↑ https://www.medrxiv.org/content/10.1101/2020.10.14.20212555v1
  27. ↑ https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm
  28. ↑ https://www.acpjournals.org/doi/10.7326/M20-5926

.

Retrieved from "https://www.physio-pedia.com/index.php?title=Long_COVID&oldid=263845"