While long COVID is a rapidly emerging health crisis across the U.S. and abroad, there is not a practical medical definition for it — and that may not be a bad thing, experts said.
Still, researchers and clinicians working to understand long COVID are no closer to identifying clear definitions for diagnosing or treating the condition. The absence of a clearly outlined algorithm for long COVID might be frustrating for physicians and their patients, but experts agree that rushing to define long COVID could present a slew of new challenges.According to Dr.
For example, should researchers focus on setting a specific number of days a person experiences fatigue after an acute COVID infection? If so, what should those ranges look like -- fatigue after 30 days? As he pointed out, there is not enough data to develop the foundational elements needed for researchers to piece together a practical definition just yet.
"I think the worst thing, particularly when an entity is not understood, is to start making definitions that are not well based in the science and preclude things that may actually be very important," said Hodder, who is the lead researcher in her university's adult hub of the RECOVER study. According to Dr. David Putrino, the director of rehabilitation innovation at Mount Sinai Health System in New York City, the focus should be on identifying the endotypes of long COVID, including an immune-mediated type, a viral persistence-mediated type, and a chronic inflammation-mediated type.
He noted that more specific definitions -- that lack foundational evidence -- could lead to overemphasis on patient presentation that could harm efforts to diagnose and treat as many patients as possible.For example, using positive PCR tests or antibody tests to identify long COVID cases would likely lead to health inequities, since people from historically underserved groups do not have equal access to those tests.
This is one area where physicians and their patients can contribute meaningfully to building the knowledge base needed to eventually develop clinical definitions for long COVID, Putrino said, acknowledging that this has not been an easy task so far. One of his main concerns is time.
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