First search definition for “Long COVID” in

The first research definition of what is meant by post-acute COVID-19, dubbed ‘Long COVID’ in children and young people, has been officially agreed upon, reveals a landmark study accepted for publication in the Archives of childhood illnesses.

The definition closely complements that proposed by the World Health Organization (WHO) for Long COVID in adults, and if widely adopted, will go a long way to strengthening the evidence base on this debilitating condition, the researchers say.

The multitude of definitions currently in use, all of which differ in the number, type and duration of symptoms, has contributed to the very large reported variations in the estimated prevalence of long COVID in children from 1% to 51%. This has hampered research efforts to date.

A consistently applied definition of Long COVID will allow researchers to reliably compare and assess studies of prevalence, disease course, and outcome, providing a more accurate picture of true disease impact. , explain the researchers.

Consensus was reached among a representative panel of 120 international experts qualified in service delivery (47), research (50) and lived experience (23), after a careful review of 49 statements each of which was scored by 1 to 9, depending on their perceived importance.

These statements were sequentially reduced into three phases (Delphi process), with the final selection of 5 being discussed in a virtual consensus meeting. These statements were then reviewed by a panel of eight young people aged 11 to 17 affected by Long COVID to reach a final agreement.

The statements included for a research definition of Long COVID in children and youth were as follows:

  • A condition in which a child or adolescent has symptoms (at least one of which is a physical symptom) that:
  • Have continued or developed after a diagnosis of COVID-19 (confirmed by one or more positive COVID tests)
  • Impact on their physical, mental or social well-being
  • interfere with some aspect of daily life (for example, school, work, home, or relationships) and
  • Persist for a minimum of 12 weeks after initial COVID-19 testing (even if symptoms have increased and decreased over this time)

These translate to: “The post-COVID-19 condition occurs in young people with a history of confirmed SARS CoV-2 infection [the virus responsible for COVID-19 infection], with at least one physical symptom persisting for a minimum of 12 weeks after the initial test that cannot be explained by another diagnosis. Symptoms impact daily functioning, may continue or develop after COVID-19 infection, and may fluctuate or relapse over time.

The researchers emphasize the need to differentiate between a clinical case definition and a research definition of Long COVID.

“It is understandable that patient groups representing people with Long COVID are concerned about a definition that could restrict access to needed services. In our view, the decision of whether a child or young person can see a healthcare professional, access any necessary support, or be referred, screened, or treated for Long COVID should be a shared decision involving the young person, their caregivers and its clinicians.

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