Challenges in Developing Long COVID Criteria

MedPageToday In a recent JAMA article, researchers provided a new approach for identifying individuals with post-acute sequelae of SARS-CoV-2 (PASC), commonly referred to as long COVID. Because this article — from Tanayott Thaweethai, PhD, and colleagues — was part of the large, federally funded U.S. RECOVER study of long COVID, it will be influential among scientists around the world who are struggling with developing a case definition for long COVID. In this opinion piece, we suggest issues that might limit the interpretation of some of the study’s findings — in particular the identification of people who have long COVID. In their introduction, Thaweethai and coauthors indicate that “Most existing PASC studies have focused on individual symptom frequency…” This is true, and it is a limitation in past studies, as either the “occurrence” of symptoms or just the “frequency” of symptoms are inadequate to help investigators understand the true burden of a post-viral symptom on a patient’s life. Studies need to incorporate severity ratings into their scales. For example, some symptoms occur frequently, but their severity is so low that they may not burden  the patient.