What you need to know as the WHO issues a formal definition

LONDON – The World Health Organization released a definition of long Covid for the first time on Wednesday, seeking to provide much-needed clarification on one of the most mysterious aspects of the coronavirus pandemic.

Here is how the United Nations health agency defined the long Covid, calling it a “post-Covid-19 condition”, the name proposed by the WHO International Classification of Diseases.

“The post COVID-19 condition occurs in people with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of COVID-19 with symptoms that last at least 2 months and cannot not be explained by another diagnosis. “WHO said.

“Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others… The symptoms can also fluctuate or relapse over time. “

WHO said a separate definition could apply to children.

The World Health Agency has previously said it has taken a long time to resolve a formal definition of long Covid because there are so many related symptoms associated with the disease.

“Within WHO as a whole this has been a major problem for us,” Dr Mike Ryan, executive director of the WHO health emergency program, said on Wednesday.

“We must remain vigilant, this pandemic is not over and it continues to cause disease, continues to cause deaths, but it also continues to have long term consequences for people around the world,” Ryan said. . “Again, in the declining numbers that we are seeing, this masks huge emerging issues in countries.”

Ryan described the definition of long Covid as “a big step forward”, before adding that the WHO’s understanding of the disease is evolving and therefore likely to change.

Most people who contract Covid-19 suffer from the common symptoms of a persistent cough, fever and shortness of breath, and recover within a few days or weeks.

However, for some, the symptoms can last much longer.

The WHO has estimated that 10-20% of Covid-19 patients have shown symptoms that persist for months after infection. These prolonged symptoms can include persistent fatigue, shortness of breath, brain fog, and depression.

Health experts say the disease is clearly a public health problem, given the substantial impact it has on society, ranging from rising healthcare costs to economic and productivity losses.

To date, there is no proven treatment or rehabilitation advice for people with long-term Covid, although post-viral syndrome continues to affect people’s daily functioning and their ability to work.

An editorial published in The Lancet on August 28 described the long Covid as “a modern medical challenge of the first order”.

The British Medical Journal hosted an online webinar last month to discuss the diagnosis, management and prognosis of long Covid.

Health experts on the panel said “deep fatigue” was a common symptom in many people with the disease, while a wide range of other symptoms included muscle and body pain, heaviness or pressure. chest, rash, palpitations, fever, headache, diarrhea, and pins. and needles.

“A very common feature is the relapsing and remitting nature of the disease, where you feel like you’ve recovered and then it comes back to you,” said Nisreen Alwan, associate professor of public health at the University of Southampton, when of the panel.

“It’s a constant cycle of disappointment, not just for you but for the people around you who really want you to get well,” she added, reflecting on her own battle against the long Covid.

Paul Garner, a professor at the Liverpool School of Tropical Medicine, said his personal battle with the disease had left him “beaten several times in the first two months”. Garner said he experienced fewer episodes over the next four months, but with continued fatigue.

Regarding the management of the disease, Alwan said that as a person with a long Covid, “you learn your habits, learn what causes complete exhaustion or the other symptoms, and try to avoid these things.”

She said it was imperative that long Covid cases be incorporated into broader Covid-19 statistics. “We are missing out on a huge opportunity to quantify and measure long Covid the same way we do with positive test results and deaths. “

In the UK, for example, around 970,000 people (1.5% of the population) had long self-declared Covid on August 1, according to data compiled by the Office for National Statistics.

The prevalence of post-viral syndrome was highest among people aged 35 to 69, women, people living in the most disadvantaged areas, people working in health or social services and those with another health problem or a disability that limits activities.