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1 Introduction
Pages 15-38

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From page 15...
... pandemic in early 2020, many individuals infected with the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) , have contin ued to experience lingering symptoms for months or even years after acute infection.
From page 16...
... Even individuals with a mild initial course of illness can develop Long COVID with severe health effects. In January of 2024, approximately 22 percent of adults with Long COVID reported significant activity limitations (NCHS, 2024)
From page 17...
... STUDY CHARGE AND SCOPE In August 2022, SSA requested that the National Academies of Sciences, Engineering, and Medicine (NASEM) convene an ad hoc consensus study committee to investigate the state of medical knowledge surrounding per sistent functional limitations related to a past SARS-CoV-2 infection.
From page 18...
... Describe any variations in functional or long-term effects based on initial infection with the various identified strains of the virus or based on vaccination status, both at the time of initial infec tion and illness or that are long-lasting; and   9. Summarize completed, on-going, or planned research, and any resultant medical knowledge, regarding similarities between this condition and impairments such as fibromyalgia or myalgic en cephalomyelitis (chronic fatigue syndrome)
From page 19...
... Ultimately, the literature selection was made by consensus judgment of the committee members based on population, study design, measurement, and clinical and functional outcomes relevant to the statement of task. In addition to examining the published literature, the committee com missioned a paper on chronic conditions similar to Long COVID, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
From page 20...
... Finally and importantly, the committee's work was informed by pre sentations from individuals with lived experience of Long COVID, made at a concurrent NASEM workshop titled Symposium on Long COVID: Examining the Working Definition, hosted by the Committee on Examining the Working Definition for Long COVID (NASEM, 2023b) ;1 by follow-up presentations from two individuals with lived experience who originally spoke at a 2022 SSA-sponsored workshop titled Long COVID: Examining Long-Term Health Effects of COVID-19 and Implications for the Social Security Administration (NASEM, 2022a)
From page 21...
... started to emerge, report ing that many previously healthy individuals had not fully recovered from COVID-19 and were experiencing lingering health problems. These patients leveraged social media platforms to share their experiences with these lin gering health effects.
From page 22...
... This recognition has been embodied in the framework for disability developed by the World Health Organization (WHO) in the International Classification of Functioning, Disability, and Health (ICF)
From page 23...
... A child under age 18 is considered disabled if he or she "has a medically determinable physi cal or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."3 A finding of disability in both adults and children depends on the severity of functional limitations arising from the claimant's impairment or combination of impairments. When SSA evaluates a disability claim based on a physical or mental impairment, it requires sufficient evidence to (1)
From page 24...
... For adults, the Listings describe, for each of the major body systems, impairments SSA considers to be severe enough to prevent a person from engaging in any gainful activity, regardless of his or her age, education, or work experi ence, and serve as a "screen-in" step. When an impairment is severe but does not meet or medically equal any of the Listings, SSA assesses in step 4 whether the applicant's physical or mental residual functional capacity allows her or him to perform past relevant work.
From page 25...
... In addition, 7 See Long COVID: A Guide for Health Professionals on Providing Medical Evidence for Social Security Disability Claims (SSA, 2023a) , Providing Medical Evidence for Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
From page 26...
... is a term "used to describe a level of work activity and earnings. Work is "substantial" if it involves doing significant physical or mental activities or a combination of both." More information on SGA can be found at https://www.ssa.gov/oact/cola/sga.html (accessed April 15, 2024)
From page 27...
... . The committee notes that while this preliminary guidance may be helpful in determining whether a disability is related to Long COVID, it does not pro vide sufficient guidance for assessing functional status or weighing severity.
From page 28...
... This is particularly true for individuals disadvantaged by their social or economic status, geographic location, or environment, and can result in preventable disparities in the burden of disease and opportuni ties to achieve optimal health (CDC, 2017)
From page 29...
... Chapter 4 reviews the literature on the functional trajectories of those long-term health effects, and includes discussion of differences among hospitalized, nonhospitalized, post-ICU, and pediatric patients. It also comments on how rehabilitation affects functional outcomes.
From page 30...
... 2024. As sociation of nirmatrelvir for acute SARS-CoV-2 infection with subsequent Long COVID symptoms in an observational cohort study.
From page 31...
... 2023. Racial/ethnic disparities in post-acute sequelae of SARS-CoV-2 infection in New York: An EHR-based cohort study from the RECOVER program.
From page 32...
... 2023a. Long COVID: A guide for health professionals on providing medical evidence for social security disability claims.
From page 33...
... This can happen even if you didn't know you had the virus. You may hear these conditions called long COVID, post-acute COVID, chronic COVID, or other terms.
From page 34...
... infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis; common symptoms include fatigue, shortness of breath, and cognitive dysfunction, and generally have an impact on everyday functioning; symptoms might be new onset after initial recovery from an acute COVID-19 episode or persist from the initial illness; symptoms might also fluctuate or relapse over time; a separate definition might be applicable for children; recognize "Long COVID" Broader Research Persistent Persistent signs and symptoms that (Behnood Community symptoms or continue or develop after acute et al., 2022) COVID-19 COVID-19 for any period of time consequences PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch01.indd 34 5/21/24 10:49 AM
From page 35...
... American Thoracic Long COVID The term that is often used to describe (ATS, 2022) Society these persistent symptoms.
From page 36...
... . Long COVID can affect nearly every organ system, with sequelae including respiratory system disorders, nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, musculoskeletal pain, and anemia.
From page 37...
... * United Kingdom National Institute for Health and Care Excellence (NICE)
From page 38...
... PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch01.indd 38 5/21/24 10:49 AM


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