2024 NASEM Long COVID Definition
Long COVID (LC) is an infection-associated chronic condition (IACC) that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems. LC manifests in multiple ways. A complete enumeration of possible signs, symptoms, and diagnosable conditions of LC would have hundreds of entries.
Any organ system can be involved, and LC patients can present with:
- single or multiple symptoms, such as shortness of breath, cough, persistent fatigue, post-exertional malaise, difficulty concentrating, memory changes, recurring headache, lightheadedness, fast heart rate, sleep disturbance, problems with taste or smell, bloating, constipation, and diarrhea.
- single or multiple diagnosable conditions, such as interstitial lung disease and hypoxemia, cardiovascular disease and arrhythmias, cognitive impairment, mood disorders, anxiety, migraine, stroke, blood clots, chronic kidney disease, postural orthostatic tachycardia syndrome (POTS) and other forms of dysautonomia, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), mast cell activation syndrome (MCAS), fibromyalgia, connective tissue diseases, hyperlipidemia, diabetes, and autoimmune disorders such as lupus, rheumatoid arthritis, and Sjogren’s syndrome.
Important Features of LC:
- LC can follow asymptomatic, mild, or severe SARS-CoV-2 infection. Previous infections may have been recognized or unrecognized.
- LC can be continuous from the time of acute SARS-CoV-2 infection or can be delayed in onset for weeks or months following what had appeared to be full recovery from acute infection.
- LC can affect children and adults, regardless of health, disability, or socioeconomic status, age, sex, gender, sexual orientation, race, ethnicity, or geographic location.
- LC can exacerbate pre-existing health conditions or present as new conditions.
- LC can range from mild to severe. It can resolve over a period of months or can persist for months or years.
- LC can be diagnosed on clinical grounds. No biomarker currently available demonstrates conclusively the presence of LC.
- LC can impair individuals’ ability to work, attend school, take care of family, and care for themselves. It can have a profound emotional and physical impact on patients and their families and caregivers .
National Academies of Sciences, Engineering and Medicine Study: Examining the Working Definition for Long COVID
The U.S. Department of Health and Human Services (HHS) sponsored the National Academies of Science Engineering and Medicine (NASEM) in Examining the Working Definition for Long COVID. NASEM conducted a series of public workshops to examine the 2022 U.S. Government (USG) working definition for Long COVID and related technical terms.
As a result of these workshops NASEM published a consensus definition; a crucial step in helping improve the health of Americans. HHS welcomes the definition. Learn more about the study on the project webpage.