Evaluating Post-COVID-19 Conditions

Post–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) conditions are referred to by a wide range of names, including long COVID, post-acute COVID-19, long-term effects of COVID, post-acute COVID syndrome, chronic COVID, long-haul COVID, late sequelae, and others, as well as the research term, post-acute sequelae of SARS-CoV-2 infection (PASC). Symptoms may include difficulty thinking or concentrating, fatigue, depression, anxiety, and other complaints. The results of studies are clouded by self-reports, lack of objective cognitive data, misattribution, and ill-defined psychological issues. Prospective cohort studies with objective assessment are needed to clarify the impact of COVID-19. While we do not dismiss the presence of long COVID or chronic COVID-19 symptoms lasting beyond a typically expected viral respiratory-transmitted syndrome, neither do we uncritically accept such a syndrome in all those who were diagnosed as having COVID-19, especially in those whose initial presentation was asymptomatic or mild. Evaluators must be astute and perform unbiased, thorough assessments and focus on objective findings while carefully assessing the potential for confounding or alternate conditions.

Long COVID-19 Neurological and Psychological Claims: Assessment Guidelines

Hirsch¹,

Mandel²,

Kertay³

et al. 2022

Pulmonary Manifestations of “Long COVID” (Post–COVID-19)

Demeter¹

2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) infections began in late 2019/early 2020 and quickly achieved pandemic proportions. Of significance is that, while most individuals recover, some do not. Those who have persistent symptoms are diagnosed with long COVID, or post-COVID syndrome. Individuals with long COVID develop symptoms related to multiple organ systems. One of the more frequent systems affected is the pulmonary system. Individuals develop shortness of breath and/or fatigue. These are sometimes unrelated to any abnormalities on physiological or radiographic testing. More frequently, however, there are abnormalities found radiographically (especially on computed tomography) and on physiological testing (generally, abnormalities in the diffusion capacity for carbon monoxide or in a 6-minute walk test with the oxygen saturation being measured during the test). This article reviews many published articles and is organized by the duration of signs, symptoms, and/or testing abnormalities after the initial diagnosis of COVID-19. The date of maximum medical improvement is suggested to be 12 months, although currently this cannot be definitively supported. More time will need to pass so that appropriate data can be collected.

Cardiac Manifestations of “Long COVID” (Post–COVID-19 Conditions)

Demeter¹

2022

The Centers for Disease Control has defined long COVID—or post–COVID-19 conditions—as a clinical syndrome reflecting a wide range of new, persistent, or recurring health problems experienced by individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]). What is known is that symptoms in these individuals diminish with time. It is unclear how long it takes to achieve maximum medical improvement. This article addresses the cardiac manifestations (including the pulmonary vascular and peripheral vascular manifestations) of long COVID. Emphasis is placed on recent articles (published in the last year) and issues relating to impairment evaluations.