Post COVID-19 condition: critical need for a clear definition and detailed pathophysiology 2022

[Sly Saint]

Tom J. Kerkhoff, Braeden T. Charlton, Brent Appelman, Michele van Vugt,

Letter to the Editor

Many people contracting a SARS-CoV-2 infection successfully recover within a few weeks. Despite this, COVID-19-like symptoms can persist in 10–60% of people.1, 2 Patients mainly suffer from dyspnoea, extreme fatigue, muscle pain, weakness and atrophy, orthostatic intolerance, concentration difficulties and post-exertional malaise. Who is at risk of developing post COVID-19 condition is currently unclear. Otherwise healthy people with a relatively mild SARS-CoV-2 infection or children do not seem to be protected against post COVID-19 condition.3 Post COVID-19 condition (also called long COVID or Post-Acute Sequelae of SARS-CoV-2) is currently defined by the World Health Organization as ‘an illness that occurs in people who have a history of probable or confirmed SARS-CoV-2 infection; usually within three months from the onset of COVID-19, with symptoms and effects that last for at least two months. The symptoms and effects of post COVID-19 condition cannot be explained by an alternative diagnosis’.4 In its current definition, we believe that without critically evaluating alternative diagnoses, post COVID-19 condition risks including different clinical entities which require a different treatment and diagnostic approach (Figure 1).

https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13108

 

[InitialConditions]

Lumping everything together under one term was always going to cause mayhem. I said this way back in early 2021. It was clear that, at the very least, you could see two distinct groups of patients emerging: those with an illness that looks like PVFS/ME, and those that are suffering from or recovering from acute organ damage and/or cadiovascular dysfunction, or the exacerbation of previous illnesses.