Preliminary definition of long COVID based on 12 symptoms developed by researchers: JAMA

SARS-CoV-2 infection has an association with persistent, relapsing, or new symptoms or other health effects occurring after acute infection. These are termed post-acute sequelae of SARS-CoV-2 infection (PASC)or long COVID. Characterizing these symptoms (PASC) requires analysis of prospectively and uniformly collected data from diverse individuals, both uninfected and infected.

In the present study, researchers used data from 9764 participants with a median age of 47 years in the RECOVER adult cohort. Thirty-seven symptoms across multiple pathophysiological domains were identified, more frequent in SARS-CoV-2–infected participants (6 months ).

The key results of the study are:

• Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms.
• Postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire/ capacity, loss/ change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements were the symptoms contributing to the PASC score.
• Among 2231 participants first infected on or after December 1, 2021, and were enrolled within 30 days of infection, researchers found 224 to be PASC positive at six months.

Major Limitations of the study are RECOVER recruitment is ongoing, and not all participants have reached the analysis stage, selection bias, and confounding.

Concluding further, they said the symptom-based PASC definition represents a first step for identifying PASC cases. There is a need for an updated algorithm for defining classification rules for PASC incorporating symptoms and biological features.

Further reading:

Thaweethai T, Jolley SE, Karlson EW, et al. Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection. JAMA. Published online May 25, 2023. doi:10.1001/jama.2023.8823