Treatment of long COVID could be hampered by lack of consensus in
identifying and diagnosing the condition, researchers say

Date:
March 9, 2022
Source:
University of California - Los Angeles Health Sciences
Summary:
In a new report, researchers say the challenges of treating long
COVID are amplified by a critical issue: we do not know what
constitutes long COVID or how to formally diagnose it, an issue
that is further exacerbated by limited research data of varying
quality and consistency.



FULL STORY ==========================================================================
In a new report, researchers say the challenges of treating long COVID
are amplified by a critical issue: we do not know what constitutes long
COVID or how to formally diagnose it, an issue that is further exacerbated
by limited research data of varying quality and consistency.


========================================================================== Early reports foretell a difficult challenge with long COVID, which
researchers call Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Some patients with prior acute COVID-19 cases have continued to report new
or persistent health issues affecting nearly every organ system.

Writing in the March 8 Annals of Internal Medicine, researchers from UCLA Health and the David Geffen School of Medicine at UCLA, with a colleague
at the University of Washington in Seattle, point out that while PASC
has been approved for inclusion and protections within the Americans
with Disabilities Act, which has strict medical and legal paperwork requirements, there is limited study data or medical consensus on what constitutes long COVID.

"The first challenge when studying any disease is knowing how to diagnose
it, and although we have seen serious medical consequences stemming
from COVID-19, we do not yet have definitive diagnostic criteria," said
Lauren E. Wisk, PhD, a researcher with the Division of Internal Medicine
and Health Services Research in the David Geffen School of Medicine at
UCLA and the UCLA Fielding School of Public Health, the article's first
author. "We believe that as more high- quality data emerges, the current
list of symptoms will become better refined, and the timing and duration
of symptoms will become clearer. So far, however, these have remained
elusive." "We need high-quality data and information that supports an
accurate diagnosis before patients can receive appropriate supportive
care and effective, disease- specific therapy," said Joann G. Elmore,
MD, MPH, professor at the David Geffen School of Medicine at UCLA and the
UCLA Fielding School of Public Health, the article's senior author. "The scientific research community will need to be able to provide data that
helps the medical community to distinguish long COVID symptoms from
those of other illnesses." Although multiple studies are in progress,
the authors say making useful comparisons across studies are nearly
impossible without uniformly applied criteria. They also point out that researchers must contend with confounding issues in study design that
can skew results, such as biases that can result from patient's own recollection and clinicians' interpretation of symptoms.

"Due to the dynamic nature of the virus itself and the technology
available to test, monitor, and treat infection, substantial variation
may exist in apparent clinical presentation of PASC," the authors
write. "Now more than ever, we must implement robust, standardized, longitudinal assessments of health and well- being across systems
and settings, including premorbid evaluation, to facilitate real-time monitoring of trends." In addition to recall and surveillance bias,
study selection bias and health care access could produce misleading
results, according to the article.

"People who were already vulnerable to socioeconomic and racial or ethnic disparities -- people who often have limited access to health care --
have disproportionately borne the burden of the COVID-19 pandemic. Now, inequities in the development, presentation and documentation of long
COVID-19 may also be accentuated," said Dr. Wisk.

The authors offer potential solutions to ensure equity in future study
and treatment, first urging the medical community to come together on a
case definition that can be consistently applied. They further recommend
that researchers implement robust and standardized measures of potential
risk factors and outcomes; consider risk of bias when designing studies;
take steps to facilitate cross-study comparisons; and to "be judicious
in application of this evolving evidence as we all strive to provide
effective and efficient care that reduces prior inequities."

========================================================================== Story Source: Materials provided by University_of_California_-_Los_Angeles_Health_Sciences.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Lauren E. Wisk, Graham Nichol, Joann G. Elmore. Toward Unbiased
Evaluation of Postacute Sequelae of SARS-CoV-2 Infection: Challenges
and Solutions for the Long Haul Ahead. Annals of Internal Medicine,
2022; DOI: 10.7326/M21-4664 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220309104520.htm

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