A call for a universal definition of the post-COVID-19 condition (PCC)

In a recent research letter published in the Open JAMA Network Journal, researchers assessed published definitions of post-coronavirus disease 2019 (COVID-19).

Study: Definition of post-COVID-19 condition among published research studies. Image Credit: hoyaphoto/Shutterstock.com

Background

In February 2023, the global number of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection reached approximately 759 million. Some people have reported lingering symptoms like fatigue and shortness of breath even after recovering from the initial COVID-19.

The World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and the National Institute for Health and Care Excellence (NICE) have each released their definitions of post-COVID-19 (CCP) status. , with some variations between them.

The definition of lasting Covid-19 symptoms is not yet universally accepted, despite increasing research on the subject.

About the study

In the present study, the researchers described the current definition of CCP as presented in existing studies.

In accordance with the reporting guideline Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), a descriptive study was conducted on the definition of CCP.

The literature search was performed with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist in the PubMed database on October 26, 2022.

Between February 1, 2020 and October 26, 2022, approximately 7,087 studies included data on CCP. The publications were analyzed to extract the definition of CCP, the type of study, the country where the research was conducted and the date of submission of the manuscript. The information was presented in chronological order.

Two researchers reviewed the studies and independently screened the abstracts and titles. They also cross-checked a 10% sample of the collected data. Publication dates were used to estimate study duration when exact submission dates were not available.

Results

Of 7087 studies, 6792 were deemed not relevant to CCP and therefore excluded. The review included 295 studies comprising two randomized clinical trials, 66 cross-sectional studies, 134 cohort studies, 45 case series or case reports, 13 case-control studies, and 35 studies using other designs.

Of these, 167 studies were conducted in European countries, while 102 studies used one of the three organizational definitions for their research.

Nearly 193 papers did not adhere to any of the three CCP definitions, while six papers were submitted for publication prior to publication of NICE’s CCP definition. Of 193 articles that did not follow any of the three definitions, 129 used their own definitions of the CCP and 64 did not define the CCP.

Conclusion

The study results showed that most of the published studies did not meet the CDC, WHO, or NICE definitions of CCP, resulting in significant heterogeneity in the definition of CCP.

Differences in definition pose a challenge when comparing interventions and outcomes between research that has reported CCP.

Variations between results can have a significant impact on the translation of results into clinical management and evaluations of the cost-effectiveness of interventions in PCC patients.

Effective clinical management of PCC requires a personalized, evidence-based approach. The need for a clear definition of PCC is crucial to ensure that evidence from clinical trials can be effectively applied to clinical management and ultimately improve the well-being of patients with PCC.