Pediatric News

Covid is rising again and a new variants have emerged known as the LF.7 Covid 19 variant and NB.1.8.1 variant derived from the omicron variant seen in 2022. Although these variants are cause of mild illness only the long term effect of them is yet to be known. Post covid condition affects 5 – 10% of the patients, the definition needs to be unified.¹

In June 2024, the National Academies of Sciences, Engineering, and Medicine (NASEM) introduced a comprehensive definition of long COVID, aiming to standardize diagnosis and enhance patient care. This definition characterizes long COVID as an infection-associated chronic condition (IACC) that manifests at least three months after a SARS-CoV-2 infection, presenting as a continuous, relapsing, or progressive disease affecting one or more organ systems.

The NASEM definition encompasses a broad spectrum of over 200 symptoms, including fatigue, cognitive dysfunction, shortness of breath, and gastrointestinal issues. It also acknowledges the emergence or exacerbation of diagnosable conditions such as interstitial lung disease, postural orthostatic tachycardia syndrome (POTS), myalgia, encephalomyelitis/chronic fatigue syndrome (ME/CFS), diabetes, and autoimmune disorders like lupus and rheumatoid arthritis. Importantly, a positive COVID-19 test is not a prerequisite for diagnosis, recognizing that many individuals lacked access to testing during the pandemic's early stages. Also, as there is no biomarker for the diagnosis of long COVID, it is diagnosed clinically.

While the inclusive nature of this definition aims to ensure that affected individuals receive appropriate recognition and care, it has sparked debate within the medical community. Some experts express concern that the broad criteria may lead to overdiagnosis or misclassification, particularly when symptoms overlap with those of other conditions. The inclusion of autoimmune diseases has been particularly contentious, as it remains unclear whether these conditions are directly triggered by SARS-CoV-2 or merely unmasked by the infection.²

Despite these concerns, the NASEM definition is considered a significant step toward a unified understanding of long COVID. It emphasizes the need for ongoing research to refine diagnostic criteria, identify biomarkers, and develop targeted treatments. The definition also highlights the importance of considering health equity, ensuring that all individuals, regardless of testing history or demographic factors, have access to appropriate care.³

 In conclusion, the 2024 NASEM definition of long COVID provides a foundational framework for clinicians, researchers, and policymakers. While it may evolve with emerging evidence, it currently serves to validate patient experiences, guide clinical practice, and inform public health strategies in addressing the long-term impacts of COVID-19.

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