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Pages 1-14

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From page 1...
... Knowledge about COVID-19, the virus, and lingering new or worsening health effects following acute infection is still embryonic, and available information will evolve as more is understood about the virus and its sequelae. Long COVID is one of many terms used to refer to persistent symptoms and new or worsening health effects following acute infection with SARS CoV-2.
From page 2...
... STUDY CHARGE AND SCOPE In August 2022, SSA requested that the Health and Medicine Division of the National Academies convene an ad hoc committee of relevant experts2 2 The committee included experts in cardiology; epidemiology; family, internal, and pediatric medicine; health metrics; health policy; immunology; infectious disease; neuropsychology; oc cupational medicine; occupational therapy; pediatric neurology; and rehabilitation medicine. PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Summary.indd 2 5/21/24 10:47 AM
From page 3...
... Any special considerations regarding the health effects' identi fication and management in special populations including preg nant people and those with underlying health conditions; d. Best practices to quantify the functional impacts of those health effects; and e.
From page 4...
... Identify distinct patterns of long-term functional decline observed in children and the frequency, severity, duration, risk factors, and associated signs or laboratory findings; 7. Identify any trends in the frequency, severity, and duration of func tional decline, including those specific to different racial, ethnic, sex, gender, geographic, or socioeconomic groups and those specific to populations with particular pre-existing or comorbid conditions; 8.
From page 5...
... The committee did not conduct a systematic review; rather, the committee developed criteria for determining relevance to the statement of task by focusing on studies involving relatively large populations followed for at least 6 months and including significant symptoms and functional outcomes. Throughout the study, recognizing that literature on Long COVID is rapidly evolving, the committee members applied their expertise to identify other studies in progress and perspectives not yet represented in publications.
From page 6...
... In addition, the broad multisystem nature of Long COVID and the fact that the associated health effects are expressed differently by age group and sex and by baseline health compound the challenge of identifying and quan tifying affected populations. Symptoms of SARS-CoV-2 infection range in severity from mild to severe, and the literature suggests that the severity of acute SARS-CoV-2 infection is a risk factor for Long COVID.
From page 7...
... Functional Impact and Risk Factors Some of the symptoms and health effects associated with Long COVID can be severe enough to interfere with an individual's day-to-day func tioning, including participation in work and school activities. Functional disability associated with Long COVID has been characterized as the inability to return to work, poor quality of life, diminished ability to PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Summary.indd 7 5/21/24 10:47 AM
From page 8...
... However, it is likely that most individuals with Long COVID applying for Social Security disability benefits will do so based on health effects not covered in the Listings. Three frequently reported health effects that can significantly interfere with the ability to perform work or school activities and may not be captured in the SSA Listings are chronic fatigue and post-exertional malaise, post-COVID-19 cognitive impairment, and autonomic dysfunction, all of which can be dif ficult to assess clinically in terms of their severity and effects on a person's functioning.
From page 9...
... Although pediatric presentations and intervention options may overlap with those in adults -- particularly among adolescents, who may be more likely than children to mimic the adult presentation and trajectory -- pediatric management of Long COVID entails specific considerations related to developmental age and/or dis abilities and history gathering. In general, children have fewer preexisting chronic health conditions compared with adults; thus, long COVID may represent a substantial change from their baseline, particularly for those that were previously healthy.
From page 10...
... As with other complex multisystem conditions, management of Long COVID relies on techniques for controlling symptoms and improving functional ability, such as pacing (i.e., balancing periods of activity and rest in daily life) , mobil ity support, social support, diet modulation, pharmacological treatment of secondary health effects, cognitive-behavioral therapy, and rehabilita tion.
From page 11...
... Recovery from Long COVID varies among individuals, and data on recovery trajectories are rapidly evolving. There is some evi dence that many people with persistent Long COVID symptoms at 3 months following acute infection, including children and adoles cents, have improved by 12 months.
From page 12...
... In addition, the demand for specialty care exceeds capacity, resulting in waitlists for the receipt of services. Similar Chronic Conditions Long COVID shares many features with other complex multisystem conditions, including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
From page 13...
... Complex, infection-associated chronic conditions affecting multiple body systems are not new, and Long COVID shares many features with such conditions as myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, and postural orthostatic tachycardia syn drome. Current theories about the pathophysiology of these con ditions include immune dysregulation, neurological disturbances, cardiovascular damage, gastrointestinal dysfunction, metabolic issues, and mitochondrial dysfunction.
From page 14...
... PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Summary.indd 14 5/21/24 10:47 AM


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