Editorial: Lancet: "Understanding long COVID: a modern medical challenge", 2021

[Andy]

"As the COVID-19 pandemic continues, the need to understand and respond to long COVID is increasingly pressing. Symptoms such as persistent fatigue, breathlessness, brain fog, and depression could debilitate many millions of people globally. Yet very little is known about the condition. The term “long COVID” is commonly used to describe signs and symptoms that continue or develop after acute COVID-19. A NICE guideline, for example, includes both ongoing symptomatic COVID-19 (from 4 to 12 weeks) and post-COVID-19 syndrome (≥12 weeks), but there is no agreed upon definition. How distinct is long COVID from other post-viral syndromes? No clear biochemical or radiological features exist to aid diagnosis, and there are potentially several phenotypes with different presentations, prognosis, and outcomes. With no proven treatments or even rehabilitation guidance, long COVID affects people's ability to resume normal life and their capacity to work. The effect on society, from the increased health-care burden and economic and productivity losses, is substantial. Long COVID is a modern medical challenge of the first order.

Clearly, the condition is of public health concern. In the UK, for example, an estimated 945 000 people (1·5% of the population) had self-reported long COVID on July 4, 2021, according to the UK Office for National Statistics, including 34 000 children aged 2–16 years. Prevalence was greatest in people aged 35–69 years, girls and women, people living in the most deprived areas, those working in health or social care, and those with another activity-limiting health condition or disability."

Open access, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01900-0/fulltext

 

[Peter T]

To state the obvious, twenty years of mismanagement of ME in the UK does not inspire confidence that overnight British medicine will miraculously get it right for Long Covid.

Whatever happens it will be a long hard struggle to get good management systems in place for Long Covid.

 

[Joan Crawford]

"Long COVID is a modern medical challenge of the first order."

Really? When clearly any other type of post viral / similar type conditions have been largely been ignored, psychologised, minimised, ridiculed, and so forth by the majority of mainstream medicine for more than half a century. What has changed? Perhaps who it affects? I dunno.

Unless there is a clear breakthrough in understanding of the underlying pathology and mechanisms, when clear answers are not forthcoming, then it'll be same old, same old. Veterans with Gulf war illness don't fair any better than pwME. Perhaps there is a bigger commitment to research at the moment. And if that fails to deliver answers?

Pw Long Covid need science. I hope this is forthcoming.

 

[Art Vandelay]

"Long COVID is a modern medical challenge of the first order."

Translation: "gaslighting this many people at once and getting away with it as we have done in the past is a big challenge".

 

[rvallee]

Old wine in old bottles, with a new sticker, uh? It's been 1.5 years and medicine is still stuck at the "should we do something?" phase, with "hell nah" as the most common answer. Truly advancing at the breakneck speed of one funeral at a time.

 

[Hutan]

A cohesive research agenda is needed to prevent research waste and improve outcomes for patients. The scientific and medical communities must collaborate to explore the mechanism and pathogenesis of long COVID, estimate the global and regional disease burdens, better delineate who is most at risk, understand how vaccines might affect the condition, and find effective treatments via randomised controlled trials.

At the same time, health-care providers must acknowledge and validate the toll of the persistent symptoms of long COVID on patients, and health systems need to be prepared to meet individualised, patient-oriented goals, with an appropriately trained workforce involving physical, cognitive, social, and occupational elements.

I wonder if someone from the current PSP on ME/CFS might like to reply to this, to note that a substantial portion of Long Covid is likely to be yet another post-viral fatigue condition, and so the outcomes of the ME/CFS PSP will be relevant. Of course, unfortunately, the current ME/CFS research base mostly tells us about what types of research are not productive, and what trial design failures should be avoided.

"health systems need to be prepared to met individualised, patient-oriented goals". sigh.

 

[Jonathan Edwards]

sigh.

Yes. This just looks like another rehab marketing pitch.