Abstract:
The term long COVID (LC) effectively describes the broad long-term disease burden of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections, encompassing individual suffering and significant socioeconomic impacts. However, its general use hampers precise epidemiological research, diagnostics and therapeutic strategies. Misinterpretations occur, for example, when population surveys are compared to studies using health record data, because both refer to these data as LC. This also emphasizes the need for different terminology. The National Institute for Health and Care Excellence (NICE) rapid guideline differentiates ongoing symptomatic COVID-19 from post-COVID conditions, yet real-world observations challenge these two subgroup definitions. We propose refining the term LC into three subgroups: ongoing symptomatic COVID-19, SARS-CoV-2 induced or exacerbated diseases and post-acute COVID condition. This stratification aids targeted diagnostics, treatment and epidemiological research. Subgroup-specific documentation using the International Classification of Diseases, Tenth Revision (ICD-10) codes ensures accurate tracking and understanding of long-term effects. The subgroup of post-acute COVID condition again includes various symptoms, syndromes and diseases like post-exertional malaise (PEM), dysautonomia or cognitive dysfunctions. In this regard, differentiation, especially considering PEM, is crucial for effective diagnostics and treatment.
摘要:
长期COVID(LC)一词有效地描述了严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染的广泛长期疾病负担,包括个人痛苦和重大的社会经济影响。然而,它的普遍使用阻碍了精确的流行病学研究,诊断和治疗策略。误解发生,例如,当人口调查与使用健康记录数据的研究进行比较时,因为两者都将这些数据称为LC。这也强调了需要不同的术语。美国国家健康与护理卓越研究所(NICE)快速指南将持续有症状的COVID-19与COVID后疾病区分开来,然而,现实世界的观察对这两个亚组定义提出了挑战.我们建议将术语LC细化为三个亚组:持续有症状的COVID-19,SARS-CoV-2引起或加剧的疾病和急性COVID后状况。这种分层有助于有针对性的诊断,治疗和流行病学研究。使用国际疾病分类的特定亚组文件,第十次修订(ICD-10)代码可确保对长期影响的准确跟踪和理解。急性COVID后病情的亚组再次包括各种症状,综合症和疾病,如劳累后不适(PEM),自主神经障碍或认知功能障碍。在这方面,分化,特别是考虑到PEM,对于有效的诊断和治疗至关重要。