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6 Overall Conclusions
Pages 215-224

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From page 215...
... , the presence of Long COVID health effects and symptoms, and consideration of other conditions and etiologies that could be causing the symptoms. Testing to diagnose acute SARS-CoV-2 infection, as well as testing capacity and behaviors, has changed dramatically over the course of the COVD-19 pandemic.
From page 216...
... Variation in incidence and preva lence estimates also stem from the heterogeneity of study designs, including choice of control groups, methods used to account for the effect of baseline health, specification of outcomes, and other methodological differences. 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.
From page 217...
... 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 functioning, 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 perform activities of daily living, decreased physical and cognitive function, and overall disability.
From page 218...
... 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 difficult to assess clinically in terms of their severity and effects on a person's functioning. Based on its review of the literature, the committee reached the follow ing conclusion: 4.
From page 219...
... Some youth with persistent symptoms experience difficulties that affect their quality of life and result in increased school absences, as well as decreased participation and performance in school, sports, and other activities. Risk factors for the development of Long COVID include acute-phase hospi talization, preexisting comorbidity, and infection with pre-Omicron vari ants.
From page 220...
... 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) , mobility support, social support, diet modulation, pharmacological treatment of secondary health effects, cognitive-behavioral therapy, and rehabilitation.
From page 221...
... Individuals with Long COVID have increased health care utilization and financial burden, which may be exacerbated if they are unable to work to gain income and or receive health insurance coverage. Members of dis advantaged groups, especially early in the pandemic, were more likely to contract SARS-CoV-2, more likely to be hospitalized with acute COVID-19, more likely to have adverse clinical outcomes, and less likely to be vac cinated, potentially increasing their risk of developing Long COVID.
From page 222...
... Social determinants of health, such as socioeconomic status, geographic location, health literacy, and race and ethnicity, affect access to health care. With respect to acute SARS-CoV-2 infection and Long COVID, adverse social determinants of health have contributed to disparities in access to SARS-CoV-2 testing; vaccination; and therapeutics, includ ing treatments for acute infection and specialized rehabilitation clinics for Long COVID.
From page 223...
... 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 syn drome, fibromyalgia, and postural orthostatic tachycardia syndrome. Current theories about the pathophysiology of these conditions include immune dysregulation, neurological disturbances, cardiovascular dam age, gastrointestinal dysfunction, metabolic issues, and mitochondrial dysfunction.
From page 224...
... PREPUBLICATION COPY -- Uncorrected Proofs A02506-Long-Term_Health_Effects_of_COVID-19_Ch06.indd 224 5/21/24 11:25 AM


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