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[[File:Long-COVID.jpg|alt=Long COVID logo with Coronavirus icon |thumb]] '''Long COVID''', '''long tail covid''', '''Post-Acute Sequelae of COVID-19''' '''(PASC)''', '''post-acute COVID-19''' and '''ongoing COVID''' are terms used to describe a group of long term health problems that are found in a significant minority of people who developed [[COVID-19]] and remain ill a number of weeks or months later.<ref name="Navabi2020">{{Cite journal | title = Long covid: How to define it and how to manage it|last = Nabavi|first = Nikki|url=https://www.bmj.com/content/370/bmj.m3489 | date = Sep 7, 2020|journal=The BMJ|volume=370|pages=bmj.m3489}}</ref><ref name="BMJ11Aug2020" /><ref name="long-haulers-redefining">{{Cite news | url=https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/ | title = Long-Haulers Are Redefining COVID-19|last = Yong|first = Ed | date = Aug 19, 2020|work=The Atlantic|access-date=2020-08-21|archive-url=|archive-date=|url-status=|issn=1072-7825|quote=}}</ref><ref name="NIHR.ac.uk15Oct2020">{{Cite web|url=https://www.nihr.ac.uk/news/living-with-covid-nihr-publishes-dynamic-themed-review-into-ongoing-covid/25891 | title = Living with COVID: NIHR publishes dynamic themed review into ‘ongoing COVID’|last = National Institute for Health Research|first = | authorlink = | date = | website = [[National Institute for Health Research]] |archive-url=|archive-date=|url-status=|access-date=2020-10-15}}</ref> The name '''Long COVID''' was coined by patient [[Elisa Perego]] in May 2020,<ref name="BMJ1Oct2020" /> and in February 2021 the [[Centers for Disease Control|CDC]] introduced the alternative name '''Post-Acute Sequelae of COVID-19''' (PASC).<ref name="PASC-blog">{{Cite web|url=https://directorsblog.nih.gov/tag/post-acute-sequelae-of-covid-19| title = Trying to Make Sense of Long COVID Syndrome | date = Jan 19, 2021|first = Francis|last = Collins | authorlink = Francis Collins |access-date = Mar 1, 2021}}</ref> In February 2020, the [[World Health Organization]] stated that the expected recovery time from [[COVID-19]] was 2 weeks for mild cases, and between three and six weeks for severe cases;<ref name="WHOFeb2020">{{Cite web|url=https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---24-february-2020 | title = WHO Director-General's opening remarks at the media briefing on COVID-19|last = World Health Organization | first = | authorlink = World Health Organization | date = Feb 24, 2020 | website = [[World Health Organization]]|language=en|archive-url=|archive-date=|url-status=|access-date=2020-09-24}}</ref> follow-up studies then identified a significant number of COVID-19 patients had remained ill much longer than this: those with long COVID.<ref name="Navabi2020" /><ref name="BMJ11Aug2020" /> A similar phenomenon to long COVID occurred after the 2003 outbreak of the similar SARS coronavirus, which lead to a [[Severe acute respiratory syndrome#post-SARS|post-SARS syndrome]] being proposed that included chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep. Another study found a subgroup SARS survivors developed [[chronic fatigue syndrome]] immediately after SARS.<ref name="Moldofsky2011">{{Cite journal | last = Moldofsky|first = Harvey | last2 = Patcai | first2 = John | date = 2011-03-24 | title = Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study|url=https://doi.org/10.1186/1471-2377-11-37|journal=BMC Neurology|volume=11|issue=1 | pages = 37|doi=10.1186/1471-2377-11-37|issn=1471-2377|pmc = 3071317|pmid=21435231}}</ref> <ref name="Lam2009">{{Cite journal|last = Lam|first = Marco Ho-Bun | last2 = Wing | first2 = Yun-Kwok | last3 = Yu | first3 = Mandy Wai-Man | last4 = Leung | first4 = Chi-Ming | last5 = Ma | first5 = Ronald C.W. | last6 = Kong | first6 = Alice P.S. | last7 = So | first7 = W.Y. | last8 = Fong | first8 = Samson Yat-Yuk | last9 = Lam | first9 = Siu-Ping | date = 2009-12-14 | title = Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors: Long-term Follow-up | url = https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415378|journal=Archives of Internal Medicine|language=en|volume=169|issue=22|pages=2142–2147|doi=10.1001/archinternmed.2009.384|issn=0003-9926}}</ref> ==Long-haulers== A "long-hauler" is someone with long COVID, meaning someone who became ill with confirmed or suspected [[COVID-19]], who has remained ill with long-term symptoms many weeks or months later after first becoming ill.<ref name="long-haulers-redefining" /><ref name="BMJ1Oct2020">{{Cite web|url=https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/ | title = Why we need to keep using the patient made term “Long Covid” | date = 2020-10-01 | last = Perego|first =Elisa | authorlink = Elisa Perego | last2 =Callard | first2 = Felicity | authorlink2 = Felicity Callard | last3 = Stras | first3 = Laurie | authorlink3 = Laurie Stras | last4 = Melville-Jóhannesson | first4 = Barbara | authorlink4 = Barbara Melville-Jóhannesson | last5 = Pope | first5 = Rachel | authorlink5 = Rachel Pope | last6 = Alwan | first6 = Nisreen A | authorlink6 = Nisreen Alwan|website=The BMJ|language=en-US|access-date=2020-10-11}}</ref> ==What is long COVID== [[File:Long-COVID-1in10.jpg|alt=Long COVID poster - 1 in 10 people with COVID-19 may develop long COVID|thumb]] Long COVID appears to be a multisystem disease, and may occur after any severity of COVID-19, including after relatively mild cases.<ref name="BMJ11Aug2020" /><ref name="BMJ1Oct2020" /> === Signs and symptoms === Patient surveys have reported that the following symptoms commonly occur in long COVID. *[[Fatigue]], which may be extreme (profound) *[[myalgia|Muscle pain]] or body aches *[[dyspnea|Breathlessness]] *[[Concentration problems]] *Inability to [[exercise]]/[[exercise intolerance]] *[[Headache]] *[[Insomnia]] or [[sleep dysfunction|problems sleeping]] *Heavy chest, a feeling of pressure on the chest, or chest pain Other reported symptoms include: *[[Anxiety]] *[[Paresis|Muscle weakness]] *[[Memory problems]] *[[Skin rash|es]] *[[Sore throat]] and [[dysphagia|difficulty swallowing]] *[[Heart palpitation]]s *[[Fever]] *[[Diarrhea]] *[[Dizziness]] *The sensation of [[pins and needles]] *[[Cough]] *[[Low-grade fever]] *[[Dysgeusia|Loss of sense of taste]] and [[anosmia|loss of sense of smell]] *[[Joint pain]] *[[new allergies and intolerances|New onset allergies]], which may lead to [[anaphylaxis|anaphylactic shock]] in some cases<ref name="Davis2021a" /> *New onset [[diabetes]]<ref name="Rubino2020">{{Cite journal|last = Rubino|first = Francesco | last2 = Amiel | first2 = Stephanie A. | last3 = Zimmet | first3 = Paul | last4 = Alberti | first4 = George | last5 = Bornstein | first5 = Stefan | last6 = Eckel | first6 = Robert H. | last7 = Mingrone | first7 = Geltrude | last8 = Boehm | first8 = Bernhard | last9 = Cooper | first9 = Mark E. | date = 2020-08-20 | title = New-Onset Diabetes in Covid-19|url=https://doi.org/10.1056/NEJMc2018688|journal=New England Journal of Medicine|volume=383|issue=8 | pages = 789–790|doi=10.1056/NEJMc2018688|issn=0028-4793|pmc = 7304415|pmid=32530585}}</ref> *New onset [[Hypertension|high blood pressure]]<ref name="Navabi2020" /><ref name="Lambert25Jul2020" /><ref name="NHSlongSep2020">{{Cite web|url=https://www.gov.uk/government/publications/covid-19-long-term-health-effects/covid-19-long-term-health-effects | title = COVID-19 Long Term Health Effects|last = National Health Service | first = | authorlink = National Health Service | date = Sep 7, 2020 | website = |archive-url=|archive-date=|url-status=|access-date=}}</ref><ref name="Yellin2020" /> *New [[Menstrual problems in ME/CFS|menstrual problems]]<ref name="Davis2021" /> {{Quote box|“A very common feature is the relapsing, remitting nature of the illness, where you feel as though you’ve recovered, then it hits you back|source=Dr. Nisreen Alwan, BMJ, Sep 2020}} ===World Health Organization Long COVID diagnostic criteria === Post COVID-19 condition ("Long COVID") definition *history of probable or confirmed SARS-CoV-2 infection *symptom(s) last 2 months from the start of COVID-19 (or 3 months for asymptomatic COVID-19) *symptom(s) can't be explained by an alternative diagnosis *no minimum number of symptoms *symptom(s) generally affect day to day functioning *new onset of symptoms - symptoms begin after recovery from COVID-19 or begin at the start of COVID-19 and persist *symptoms can fluctuate or improve then relapse over time Common symptoms: *[[fatigue]] *[[shortness of breath]] *[[cognitive dysfunction]] but there are others Other symptoms: *[[abdominal pain]], [[menstrual and period problems]], [[parosmia|altered smell]]/[[dysgeusia|taste]], [[anxiety]] , [[blurred vision]], [[chest pain]], [[cognitive dysfunction]] (e.g. brain fog), [[cough]], [[depression]], [[dizziness]], [[fatigue]], intermittent [[fever]], gastrointestinal issues ([[diarrhoea]], [[constipation]], [[acid reflux]]), [[headache]], [[memory problems|memory issues]], [[arthralgia|joint pain]], [[myalgia|muscle pain]], [[muscle spasm]]s, [[nerve pain|neuralgias]] (nerve pain), [[new allergies and intolerances|new onset allergies]], [[paresthesia|pins and needles sensations]], [[post-exertional malaise]], [[dyspnea|shortness of breath]], [[:category:sleep disorders|sleep disorder]]s, [[heart palpitations|tachycardia/palpitations]], [[tinnitus|tinnitus and other hearing issues]] <br>Notes: *Children - separate criteria may be needed *Clusters - clusters of 2 or more related symptoms may occur together<ref name="WHO-longcovid-criteria" /> {{See also|World Health Organization Long COVID diagnostic criteria}} === Four different syndromes === A recent review suggested that long COVID may actually be four differing syndromes: * [[Post-COVID-19 illness#pics|Post-Intensive Care Syndrome]] * [[Postviral fatigue syndrome|Postviral Fatigue Syndrome]] (ME/CFS) * [[Post-Acute Sequelae of COVID-19|Long Term COVID Syndrome]] * Permanent organ damage Patients with long COVID may have several syndromes at once.<ref name="NIHR15Oct2020" /> == COVID-19 testing == While some people with long COVID did have a positive test result for COVID-19, others were denied tests due to the limited availability of tests at the time, or they tested negative but were found to have clear evidence of COVID-19 from blood count tests or chest X-rays.<ref name="NIHR15Oct2020">{{Cite web|url=https://evidence.nihr.ac.uk/themedreview/living-with-covid19 | title = Living with covid-19. A dynamic review of the evidence around ongoing covid-19 symptoms (often called long covid). | last = NIHR|first = | authorlink = | date = October 2020 | website = evidence.nihr.ac.uk|language=en-GB|archive-url=|archive-date=|url-status=|access-date=2020-10-15}}</ref><ref name="Kingstone2020" /> Some people with Long COVID have described never having a cough or fever at the start of their illness, but developed these symptoms later. Long COVID diagnosis does not depend on a previous positive test.<ref name="NIHR15Oct2020" /><ref name="Kingstone2020" /> ==Clinical findings == There is no blood test or diagnostic biomarker to identify patients with long COVID. A study of UK patients by Dennis et al (2020) found that just over 10% of long COVID patients had abnormal findings on the standard tests and did not find an association between standard test results and degree of organ damage or long COVID severity.<ref name="Dennis2020" /> The same study used MRI scans combined with patient questionnaires to assess organ damage, finding that multi-organ impairment was common in people with long COVID, despite the fact that 80% had not been hospitalized for [[COVID-19]], the average patient age was forty-four years old, and rates of pre-existing conditions were also low.<ref name="Dennis2020" /> ==Research findings == {{Main article|page_name=Long COVID pathophysiology}} Surveys of data collected and published by long haulers using social media were the first evidence of what symptoms and health problems were caused by long COVID.<ref name="bodypoliticMay2020" /> Later academic studies confirmed many of the initial long hauler survey findings, although many only involved patients discharged from hospital,<ref name="Puntmann2020" /> patients who had been able to access early testing and tested positive, or patients who had sought medical care in a particular location.<ref name="Arnold2020b" /> People with mild COVID-19 symptoms, leaving people denied testing and those who may have had false negative test results and people who tested positive but were asymptomatic underrepresented in long COVID research.<ref name="bodypoliticMay2020" /> ==Treatment== ===Pacing=== Pacing is a method of activity management which aims to adapt everday activities in order to avoid relapses or increased symptoms. {{See also|Pacing}} ===Exercise therapy === ME/CFS patient groups have raised concerns about the use of [[graded exercise therapy]] (GET) in long COVID patients and a similar warning has been issued by [[NICE]] in the [[United Kingdom|UK]].<ref name="GETcovidForwardME" /> Graded exercise therapy, which is sometimes incorrectly referred to as "activity management" involves patients initially reducing their activity levels to a level that prevents regular crashes, and then typically increasing activity by 10% each week regardless of any increased symptoms or worsening illness. In graded exercise patients are told to ignore deterioration or increased symptoms and "push through" them. ====Theory and evidence ==== In graded exercise therapy patients are told that their symptoms are caused only by [[deconditioning|inactivity]] and other "bad habits" rather than an underlying illness. These assumptions have very weak evidence, and significant evidence exists of underlying illness in ME/CFS; there is a lack of research about exercise therapy for long COVID illness<ref name="Navabi2020" /> but some symptoms are inconsistent with this "deconditioning" assumption and some research has found physical abnormalities in some patients weeks or month after infection. Surveys of ME/CFS patients have consistently shown that large numbers of patients deteriorate as a result of graded exercise therapy, and a significant number become severely ill and never return to the level of functioning they had before the treatment. ==<span id="MECFS">ME/CFS</span>== [[Postviral fatigue syndrome]] is one of the previous names used for [[Myalgic Encephalomyelitis]] (ME), sometimes known as [[Chronic fatigue syndrome|Chronic Fatigue Syndrome]] (CFS), and it commonly begins immediately after events such as a virus, bacterial or other infection.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17= Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6| url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> ME has been a sequela of over [[Epidemic myalgic encephalomyelitis|one hundred outbreaks]], in addition to sporadic infections. ME/CFS is not normally diagnosed until symptoms have persisted for six months or more, and tests must be run to exclude other possible causes of the symptoms.<ref name="SEID2015">{{Citation|last = Institute of Medicine | authorlink = Institute of Medicine | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness|location=Washington, DC|publisher=The National Academies Press | date = 2015 | url=https://www.ncbi.nlm.nih.gov/books/NBK284902/}}</ref> Some contagious diseases including [[Epstein-Barr virus]], certain [[enterovirus]]es,<ref name="ICC2011primer" /> and the [[Severe acute respiratory syndrome|SARS]] coronavirus,<ref name="Moldofsky2011" /> have caused outbreaks of ME/CFS. It is not yet known how likely it is for ME/CFS to begin immediately after COVID-19 illness, although around 10% people with certain viruses are known to develop ME/CFS, and according to [[the BMJ]] around 10% of people with COVID-19 have developed long COVID. A significant number of those with long COVID have been found to develop ME/CFS, but it is not known how common this is.<ref name="BMJ11Aug2020" /><ref name="NIHR15Oct2020" /> According to [[Infectious disease|infectious diseases]] and [[Immune system|immunology]] researcher, [[Sonya Marshall-Gradisnik]], there appeared to be a correlation between the illnesses.<blockquote>"The symptom overlap between [[ME/CFS]] and long-COVID is quite astounding," Professor Marshall-Gradisnik said.Those symptoms can be [[fatigue]], they have [[pain]], [[joint pain]], [[Sleep dysfunction|sleep disturbances]], [[headaches]], they have [[Cardiac dysfunctions|cardiac]] changes. Notably, they've got [[brain fog]] and [[Cognitive dysfunction|cognitive]] issues with [[Memory problems|memory]], [and] [[Word-finding problems|word choice]] becomes a problem."<ref>{{Cite news | url=https://www.abc.net.au/news/2022-03-18/long-covid-and-chronic-fatigue-links/100916990 | title = 'Symptom overlap is quite astounding': Researchers probe links between long-COVID and chronic fatigue | date = 2022-03-17|work=ABC News|access-date=2022-06-09|language=en-AU}}</ref></blockquote> ==Patient surveys == '''Not peer reviewed''' * May 2020, [https://patientresearchcovid19.com/research/report-1/ What Does COVID-19 Recovery Actually Look Like? An Analysis of the Prolonged COVID-19 Symptoms Survey by Patient-Led Research Team]<ref name="bodypoliticMay2020">{{Cite web|url=https://docs.google.com/document/u/0/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/mobilebasic | title = What Does COVID-19 Recovery Actually Look Like? An Analysis of the Prolonged COVID-19 Symptoms Survey by Patient-Led Research Team | date = May 11, 2020|vauthors=Assaf G, Davis H, McCorkell L, Wei H, O'Neil B, Akrami A, Low R, Mercier J, A A, L T, C A, S M, N L, H N, D JD, S}}</ref> - by [[Body Politic|Body Politic and Patient Led Research Collaborative]] ::Data collected: Apr 21 - May 2 2020. Respondents: 640 * Jul 2020, [https://static1.squarespace.com/static/5e8b5f63562c031c16e36a93/t/5f459ef7798e8b6037fa6c57/1598398215120/2020+Survivor+Corps+COVID-19+%27Long+Hauler%27+Symptoms+Survey+Report+%28revised+July+25.4%29.pdf COVID-19 “Long Hauler” Symptoms Survey Report]<ref name="Lambert25Jul2020">{{Cite web|url=https://static1.squarespace.com/static/5e8b5f63562c031c16e36a93/t/5f459ef7798e8b6037fa6c57/1598398215120/2020+Survivor+Corps+COVID-19+%27Long+Hauler%27+Symptoms+Survey+Report+%28revised+July+25.4%29.pdf | title=COVID-19 “Long Hauler” Symptoms Survey Report|last = Lambert | first = Natalie J | author-link = Natalie Lambert | last2 = Survivor Corps | authorlink2 = Survivor Corps|publisher=Indiana University School of Medicine | date = Jul 2020}}</ref> - with Survivor Corps ::Data collected: Jul 25, 2020. Respondents: 1,567+ :: :* Dec 2020, [https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2 Charactering Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact] - by [https://patientresearchcovid19.com/ Body Politic and Patient Led Research Collaborative] :** Respondents: 3,762+ ==Notable studies== *Jul 24, 2020, Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)<ref name="Puntmann2020">{{Cite journal | last = Puntmann | first = Valentina O. | last2 = Carerj | first2 = M. Ludovica | last3 = Wieters | first3 = Imke | last4 = Fahim | first4 = Masia | last5 = Arendt | first5 = Christophe | last6 = Hoffmann | first6 = Jedrzej | last7 = Shchendrygina | first7 = Anastasia | last8 = Escher | first8 = Felicitas | last9 = Vasa-Nicotera | first9 = Mariuca | date = 2020-07-27 | title = Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)|url=https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916|journal=JAMA Cardiology|language=en|doi=10.1001/jamacardio.2020.3557|issn=2380-6583}}</ref> - [https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916 (Full text)] *Aug 11, 2020, Management of post-acute covid-19 in primary care<ref name="BMJ11Aug2020">{{cite journal | title = Management of post-acute covid-19 in primary care|last = Greenhalgh|first = Trisha | authorlink = Trisha Greenhalgh | first2 = Matthew | last2 = Knight | authorlink2 = Matthew Knight | authorlink3 = Christine A'Court | first3 = Christine | last3 = A'Court | first4 = Maria | last4 = Buxton | first5 = Laiba | last5 = Husain|journal=The BMJ | date = Aug 11, 2020|volume=370|doi=10.1136/bmj.m3026|pages=m3026 | url = https://doi.org/10.1136/bmj.m3026}}</ref> - [https://doi.org/10.1136/bmj.m3026 (Full text)] *Aug 20, 2020, New-Onset Diabetes in Covid-19<ref name="Rubino2020" /> - [https://www.nejm.org/doi/full/10.1056/NEJMc2018688 (Full text)] *Oct 1, 2020, Long-term consequences of COVID-19: research needs<ref name="Yellin2020">{{Cite journal|last = Yelin | first = Dana | last2 = Wirtheim | first2 = Eytan | last3 = Vetter | first3 = Pauline | last4 = Kalil | first4 = Andre C. | last5 = Bruchfeld | first5 = Judith | last6 = Runold | first6 = Michael | last7 = Guaraldi | first7 = Giovanni | last8 = Mussini | first8 = Cristina | last9 = Gudiol | first9 = Carlota | date = 2020-10-01 | title = Long-term consequences of COVID-19: research needs|url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30701-5/abstract|journal=The Lancet Infectious Diseases|language=English|volume=20|issue=10|pages=1115–1117|doi=10.1016/S1473-3099(20)30701-5|issn=1473-3099|pmid=32888409}}</ref> - [https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30701-5/fulltext (Full text)] *Oct 14, 2020, Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID<ref name="Kingstone2020">{{Cite journal | last = Kingstone | first = Tom | authorlink = | last2 = Taylor | first2 = Anna K. | authorlink2 = | last3 = O'Donnell | first3 = Catherine A. | authorlink3 = | last4 = Atherton | first4 = Helen | authorlink4 = | last5 = Blane | first5 = David N. | authorlink5 = | last6 = Chew-Graham | first6 = Carolyn A. | authorlink6 = Carolyn Chew-Graham | date = 2020-10-14 | title = Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID|url=https://bjgpopen.org/content/early/2020/10/12/bjgpopen20X101143|journal=BJGP Open|language=en|volume=|issue=|pages=|doi=10.3399/bjgpopen20X101143|issn=2398-3795|pmc=|pmid=33051223|access-date=|quote=|via=}}</ref> - [https://bjgpopen.org/content/bjgpoa/early/2020/10/12/bjgpopen20X101143.full.pdf (Full text)] *Oct 16, 2020, Multi-organ impairment in low-risk individuals with long COVID<ref name="Dennis2020">{{Cite journal|last = Dennis | first = Andrea | authorlink = | last2 = Wamil | first2 = Malgorzata | authorlink2 = | last3 = Kapur | first3 = Sandeep | authorlink3 = | last4 = Alberts | first4 = Johann | authorlink4 = | last5 = Badley | first5 = Andrew D. | authorlink5 = | last6 = Decker | first6 = Gustav Anton | authorlink6 = | last7 = Rizza | first7 = Stacey A. | last8 = Banerjee | first8 = Rajarshi | last9 = Banerjee | first9 = Amitava | authorlink9 = Amitava Banerjee | date = 2020-10-16 | title = Multi-organ impairment in low-risk individuals with long COVID|url=https://www.medrxiv.org/content/10.1101/2020.10.14.20212555v1|journal=medRxiv|language=en|volume=|issue=|pages=2020.10.14.20212555|doi=10.1101/2020.10.14.20212555|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://doi.org/10.1101/2020.10.14.20212555 (Full text)] *Oct 21, 2020, Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App<ref name="Sudre2020a">{{Cite journal|last = Sudre | first = Carole H. | authorlink = | last2 = Murray | first2 = Benjamin | authorlink2 = | last3 = Varsavsky | first3 = Thomas | authorlink3 = | last4 = Graham | first4 = Mark S. | authorlink4 = | last5 = Penfold | first5 = Rose S. | authorlink5 = | last6 = Bowyer | first6 = Ruth C. | authorlink6 = | last7 = Pujol | first7 = Joan Capdevila | last8 = Klaser | first8 = Kerstin | last9 = Antonelli | first9 = Michela | date = 2020-10-19|others= | title = Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App | url = https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1|journal=medRxiv|language=en|volume=|issue=|pages=2020.10.19.20214494|doi=10.1101/2020.10.19.20214494|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1.full-text (Full text)] *Dec 2020 (pre-print) / Jul 15, 2021, Characterizing long COVID in an international cohort: 7 months of symptoms and their impact<ref name="Davis2021a">{{Cite journal|last = Davis | first = Hannah E. | authorlink = Hannah Davis | last2 = Assaf | first2 = Gina S. | last3 = McCorkell | first3 = Lisa | last4 = Wei | first4 = Hannah | last5 = Low | first5 = Ryan J. | last6 = Re'em | first6 = Yochai | last7 = Redfield | first7 = Signe | last8 = Austin | first8 = Jared P. | last9 = Akrami | first9 = Athena | date = 2021-07-15 | title = Characterizing long COVID in an international cohort: 7 months of symptoms and their impact|url=https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/abstract|journal=EClinicalMedicine|language=English|volume=38|issue=|pages=101019|doi=10.1016/j.eclinm.2021.101019|pmc=PMC8280690|pmid=34308300|issn=2589-5370}}</ref> - [https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00299-6/abstract (Abstract)] *Dec 2020, Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria<ref name="PMC7737559">{{Cite journal|last = Raveendran | first = A.V. | date = 2021 | title=Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737559/|journal=Diabetes & Metabolic Syndrome|volume=15|issue=1|pages=145–146|doi=10.1016/j.dsx.2020.12.025|issn=1871-4021|pmc=7737559|pmid=33341598}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737559/ (Full text)] *Dec 20, 2020, Patient outcomes after hospitalisation with COVID-19 and implications for follow-up; results from a prospective UK cohort<ref name="Arnold2020b">{{Cite journal | last = Arnold | first = David T. | authorlink = David Arnold | last2 = Hamilton | first2 = Fergus W. | last3 = Milne | first3 = Alice | last4 = Morley | first4 = Anna J. | last5 = Viner | first5 = Jason | last6 = Attwood | first6 = Marie | last7 = Noel | first7 = Alan | last8 = Gunning | first8 = Samuel | last9 = Hatrick | first9 = Jessica | date = 2021-04-01 | title = Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort|url=https://thorax.bmj.com/content/76/4/399|journal=Thorax|language=en|volume=76|issue=4 | pages = 399–401|doi=10.1136/thoraxjnl-2020-216086|issn=0040-6376|pmid=33273026}}</ref> - [https://thorax.bmj.com/content/76/4/399 (Full text)] - from the DISCOVER project *Jan 18, 2021, Will COVID-19 lead to myalgic encephalomyelitis/chronic fatigue syndrome?<ref name="Komaroff2021a">{{Cite journal | last = Komaroff|first = Anthony L. | authorlink = Anthony Komaroff | last2 = Bateman | first2 = Lucinda | authorlink2 = Lucinda Bateman | date = 2021 | title=Will COVID-19 Lead to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?|url=https://www.frontiersin.org/articles/10.3389/fmed.2020.606824/full?s=03|journal=Frontiers in Medicine|language=English|volume=|issue=|pages=|doi=10.3389/fmed.2020.606824|issn=2296-858X|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.frontiersin.org/articles/10.3389/fmed.2020.606824/full?s=03 (Full text)] *Mar 27, 2021, COVID-19 Survivors’ Reports of the Timing, Duration, and Health Impacts of Post-Acute Sequelae of SARS-CoV-2 (PASC) Infection<ref name="Lambert2021a">{{Cite journal|last = Lambert | first = Natalie | authorlink = Natalie Lambert | last2 = Corps | first2 = Survivor | authorlink2 = Survivor Corps | last3 = El-Azab | first3 = Sarah A. | authorlink3 = | last4 = Ramrakhiani | first4 = Nathan S. | authorlink4 = | last5 = Barisano | first5 = Anthony | authorlink5 = | last6 = Yu | first6 = Lu | authorlink6 = | last7 = Taylor | first7 = Kaitlyn | last8 = Esperanca | first8 = Alvaro | last9 = Downs | first9 = Charles A. | date = 2021-03-27 | title = COVID-19 Survivors’ Reports of the Timing, Duration, and Health Impacts of Post-Acute Sequelae of SARS-CoV-2 (PASC) Infection | url = https://www.medrxiv.org/content/10.1101/2021.03.22.21254026v2|journal=medRxiv|language=en|volume=|issue=|pages=2021.03.22.21254026|doi=10.1101/2021.03.22.21254026|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://doi.org/10.1101/2021.03.22.21254026 (Full text)] *May 11, 2021, Mayo Clinic Proceedings: Post COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at the Mayo Clinic and Characteristics of the Initial Patient Cohort<ref name="mayo2021a">{{Cite journal | last = Vanichkachorn | first = Greg | last2 = Newcomb | first2 = Richard | last3 = Cowl | first3 = Clayton T. | last4 = Murad | first4 = M. Hassan | last5 = Breeher | first5 = Laura | last6 = Miller | first6 = Sara | last7 = Trenary | first7 = Michael | last8 = Neveau | first8 = Daniel | last9 = Higgins | first9 = Steven | date = 2021-07-01 | title = Post–COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at Mayo Clinic and Characteristics of the Initial Patient Cohort|url=https://www.mayoclinicproceedings.org/article/S0025-6196(21)00356-6/abstract|journal=Mayo Clinic Proceedings|language=English|volume=96|issue=7|pages=1782–1791|doi=10.1016/j.mayocp.2021.04.024|issn=0025-6196|pmid=34218857}}</ref> - [https://www.mayoclinicproceedings.org/article/S0025-6196(21)00356-6/abstract (Abstract)] *Jun 7, 2021, Insights from ME/CFS May Help Unravel the Pathogenesis of Post-Acute COVID-19 Syndrome<ref name="Komaroff2021b">{{Cite journal | last = Komaroff|first = Anthony L. | authorlink = Anthony Komaroff | last2 = Lipkin | first2 = W. Ian | authorlink2 = Ian Lipkin | date = 2021-06-07 | title = Insights from myalgic encephalomyelitis/chronic fatigue syndrome may help unravel the pathogenesis of postacute COVID-19 syndrome|url=https://www.cell.com/trends/molecular-medicine/abstract/S1471-4914(21)00134-9|journal=Trends in Molecular Medicine|language=English|volume=|issue=|pages=|doi=10.1016/j.molmed.2021.06.002|issn=1471-4914|pmc=|pmid=34175230|access-date=|quote=|via=}}</ref> - [https://www.cell.com/trends/molecular-medicine/fulltext/S1471-4914(21)00134-9 (Full text)] *Jun 23, 2021, Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms<ref name="Proal2021">{{Cite journal | last = Proal|first = Amy D. | authorlink = Amy Proal | last2 = VanElzakker | first2 = Michael B. | authorlink2 = Michael VanElzakker | date = 2021 | title=Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms|url=https://www.frontiersin.org/articles/10.3389/fmicb.2021.698169/full|journal=Frontiers in Microbiology|language=English|volume=|issue=|pages=|doi=10.3389/fmicb.2021.698169|issn=1664-302X|pmc=8260991|pmid=34248921|access-date=|quote=|via=}}</ref> - [https://doi.org/10.1101/2020.12.24.20248802 (Full text)] *Oct 2021, A clinical case definition of post COVID-19 condition by a Delphi consensus<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus | date =Oct 6, 2021 |publisher=[[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | authorlink4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | authorlink6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref> [https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 (Full text)] * Feb 2024, [https://www.nature.com/articles/s41593-024-01576-9 Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment]<ref>{{Cite journal|title=Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment|date=2024-02-22|url=https://www.nature.com/articles/s41593-024-01576-9|journal=Nature Neuroscience|pages=1–12|last=Greene|first=Chris|last2=Connolly|first2=Ruairi|last3=Brennan|first3=Declan|last4=Laffan|first4=Aoife|last5=O’Keeffe|first5=Eoin|last6=Zaporojan|first6=Lilia|last7=O’Callaghan|first7=Jeffrey|last8=Thomson|first8=Bennett|last9=Connolly|first9=Emma|last10=Argue|first10=Ruth|last11=Martin-Loeches|first11=Ignacio|language=en|doi=10.1038/s41593-024-01576-9|issn=1546-1726}}</ref> ::Report including the [[World Health Organization Long COVID diagnostic criteria]] ==Articles and editorials == *Jun 15, 2021, White Paper: A Detailed Study of Patients with Long-Haul COVID<ref name="Fairthealth2021">{{Cite web|url=https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf | publisher=FAIR Health | date = Jun 18, 2020 | title = A Detailed Study of Patients with Long-Haul COVID: An Analysis of Private Healthcare Claims. A FAIR Health White Paper}}</ref> [https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf (Full text)] *Jun 24, 2021, Covid-19: Third of people infected have long term symptoms<ref name="ODowd2021">{{Cite journal|last = O'Dowd | first = Adrian | date = 2021-06-24 | title = Covid-19: Third of people infected have long term symptoms|url=https://www.bmj.com/content/373/bmj.n1626|journal=BMJ|language=en|volume=373|pages=n1626|doi=10.1136/bmj.n1626|issn=1756-1833|pmid=34168002}}</ref> [https://www.bmj.com/content/373/bmj.n1626 (Editorial)] ==Presentations, interviews and videos== *Aug 2020, [https://solvecfs.org/wp-content/uploads/2020/08/Post-COVID%20ME-to%20Solve.pdf Will Covid-19 lead to ME/CFS in some people?] - presentation - Dr [[Anthony Komaroff]] *Jul 2020, [https://www.youtube.com/watch?v=IIeOoS_A4c8 Message in a Bottle] video - [[LongCovidSOS]] *Jun 2020, [https://www.biomax.com/lib/press-releases/Initial-Result-Announcment_English.pdf Health of Corona Patients at Home in Alarmingly Poor Health Even After Several Months - Dutch Lung Foundation] - Press release (English translation) - [https://www.ad.nl/binnenland/longfonds-gezondheid-thuiszittende-coronapatienten-schrikbarend-slecht~a45346fe/ Dutch] ==Letters and blogs== *May 2020, [http://somatosphere.net/2020/mild-covid.html/ Very, very mild: Covid-19 symptoms and illness classification] - [[Felicity Callard]] *Jul 2020, [https://meassociation.org.uk/wp-content/uploads/ForwardME-Letter-re-Covid-19-Management-and-Exercise-Caution-27.08.20.pdf Letter re Covid-19 Management and Exercise Caution]<ref name="GETcovidForwardME">{{Cite web|url=https://meassociation.org.uk/wp-content/uploads/ForwardME-Letter-re-Covid-19-Management-and-Exercise-Caution-27.08.20.pdf | date = 2020-08-27 | last = Forward-ME | authorlink = Forward-ME| title = Letter re Covid-19 Management and Exercise Caution}}</ref> - [[Forward-ME]] *Sep 2020, [https://mecfsresearchreview.me/2020/09/17/understanding-long-covid-a-shortcut-to-solving-me-cfs/?#symptoms Understanding Long Covid, A Shortcut to Solving ME/CFS?] - [[Simon McGrath]] *Sep 2020, [https://wellcomeopenresearch.org/articles/5-224 Why the Patient-Made Term 'Long Covid' is needed] - Open Letter *Oct 2020, [https://blogs.bmj.com/bmj/2020/10/01/why-we-need-to-keep-using-the-patient-made-term-long-covid/ Why we need to keep using the patient made term “Long Covid”] - [[The BMJ]] *Jan 2021, [https://directorsblog.nih.gov/tag/post-acute-sequelae-of-covid-19/ Trying to Make Sense of Long COVID Syndrome] - Dr. Francis Collins, CDC director ==National and international health bodies== *[https://doi.org/10.1136/bmj.m2912 NICE cautions against using graded exercise therapy for patients recovering from COVID-19]<ref name="NICEcautionBMJ">{{Cite journal | last = Torjesen | first = Ingrid | date = 2020-07-21 | title = NICE cautions against using graded exercise therapy for patients recovering from covid-19|url=https://www.bmj.com/content/370/bmj.m2912|journal=The BMJ|language=en|volume=370|doi=10.1136/bmj.m2912|issn=1756-1833|pmid=32694164}}</ref> ==News articles == * Feb 2024, [https://www.nature.com/articles/s41593-024-01576-9 Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment] * Oct 2020, [https://www.theguardian.com/world/2020/oct/21/women-aged-50-60-at-greatest-risk-of-long-covid-experts-suggest Women aged 50-60 at greatest risk of ‘long Covid’, experts suggest] - The Guardian * Oct 2020, [https://www.wsj.com/articles/these-doctors-have-long-term-covid-now-theyre-pushing-for-better-care-11603144474 These Doctors Have Long-Term Covid. Now They’re Pushing for Better Care.] - Wall Street Journal * Oct 2020, [https://time.com/5897992/long-haul-coronavirus-me-cfs/ Have We Been Thinking About Long-Haul Coronavirus All Wrong?] - Time * Oct 2020, [https://www.nihr.ac.uk/news/living-with-covid-nihr-publishes-dynamic-themed-review-into-ongoing-covid/25891 Living with COVID: NIHR publishes dynamic-themed review into 'ongoing COVID'] - National Institute of Health Research * Oct 2020, [https://www.theguardian.com/world/2020/oct/04/long-covid-the-evidence-of-lingering-heart-damage Long Covid: the evidence of lingering heart damage] - The Observer * Sep 2020, [https://www.bbc.co.uk/news/uk-england-leicestershire-54106073 Coronavirus patient unable to work six months on] - BBC News * Aug 2020, [https://www.huffingtonpost.co.uk/entry/long-term-symptoms-of-covid-19-identified-in-study-of-hospital-patients_uk_5f2bc0f6c5b64d7a55eefcfa The Most Common Long-Term Symptoms Of Covid-19] - HuffPost UK * Aug 2022, [https://www.nature.com/articles/d41586-022-02140-w Long-COVID treatments: why the world is still waitin] - Nature * Aug 2022, [https://www.statnews.com/2022/08/19/long-covid-plan-good-start-needs-to-go-further/ Biden’s long Covid plan is a good start. But it needs to go further] - Ryan Prior and Kimberly Knackstedt, Stat News * Aug 2022, [https://www.latimes.com/opinion/story/2022-08-21/long-covid-treatment-research Op-Ed: We're starting to understand long COVID. Next we can fight it] * Jul 2020, [https://www.sciencemag.org/news/2020/07/brain-fog-heart-damage-covid-19-s-lingering-problems-alarm-scientists From ‘brain fog’ to heart damage, COVID-19’s lingering problems alarm scientists] - Science Mag ==Articles for journalists covering Long COVID == * [https://www.cjr.org/covering_the_pandemic/how-to-cover-covid-19-patients-sensitively.php How to cover COVID-19 patients sensitively] - Fiona Lowenstein, Columbia Journalism Review *[https://www.wearebodypolitic.com/bodytype/2021/7/6/long-covid-guide Body Politic's Comprehensive Guide to Covering Long COVID] - Fiona Lowenstein *[https://centerforhealthjournalism.org/resources/lessons/what-reporters-need-know-when-covering-long-covid Long COVID coverage often falls short, but here's how reporters can do better] - Fiona Lowenstein, Center for Health Journalism *2021, [https://www.theopennotebook.com/2021/01/26/how-to-report-with-accuracy-and-sensitivity-on-contested-illnesses/ How to Report with Accuracy and Sensitivity on Contested Illnesses] - Julie Rehmeyer, Open Notebook ==See also== *[[List of famous people with long COVID]] *[[List of open letters about long COVID]] *[[Post-COVID-19 illness]] *[[COVID-19]] coronavirus disease 19 *[[Myalgic encephalomyelitis|Myalgic encephalomyelitis and chronic fatigue syndrome]] *[[Postviral fatigue syndrome]] *[[Post-Ebola syndrome]] *[[Encephalitis lethargica]] *[[Paul Garner]] *[[Nisreen Alwan]] *[[Blood-brain barrier]] ==Learn more== *[https://www.gov.uk/government/publications/covid-19-long-term-health-effects/covid-19-long-term-health-effects COVID-19 Long Term Health Effects] *[https://www.bmj.com/sites/default/files/infographics/1353078336/static-infographic/background.png Infographic: "Long covid" in primary care] - BMJ journal * List of long COVID studies (draft) - [[MEAction|#MEAction]] ==References== {{reflist}} [[Category:Potential comorbidities]] [[Category:Diagnoses]] [[Category:Long COVID]]
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