Evidence-Based Diagnoses of Long Covid

Jan 26, 2023 - By Lucy Li, University of Washington Information School Capstone Student   The largest workers’ compensation insurer in New York State, the New York State Insurance Fund (NYSIF), issued a report last week highlighting the impact Long COVID had on the workforce. The report found that nearly one-third of COVID-19 work compensation claimants, 31% of the 3,139 total, had Long COVID. Among these, 18% were unable to return to work for more than one year and 40% returned within 60 days but continued to receive medical treatments. The report shed light upon the complex aftereffects of COVID-19.   Long COVID was defined by the U.S. Department of Health and Human Services (HSS) in collaboration with the Centers for Disease Control and Prevention (CDC), the National Institute of Health (NIH), patient groups, medical societies, and government experts that refer to the long-term effects from the COVID-19 infection, also known in the CDC’s term as Post-COVID-19 Conditions (PCC). According to the latest (December 2022) Household Pulse Survey conducted by the National Center for Health Statistics (NCHS) in partnership with the Census Bureau, it was estimated that 14.4% adults in the U.S. experienced Long COVID. And 28.1% experienced Long COVID after first having COVID-19.   The CDC, however, cautioned on Long COVID data variances. The wide range of ongoing health problems, the people involved in the study, and the data collection approaches could lead to different estimates of Long COVID statistics. According to the CDC, PCC could only start to be identified at least four weeks after infection with the COVID-19 virus, and it is not one illness. Symptoms of Long COVID range from general tiredness or fatigue to respiratory and heart conditions like cough and chest pain, and could also include a multitude of neurological and digestive problems. The CDC pointed out that it could be difficult to explain, diagnose, or manage these conditions. According to DynaMed (accessed through HEALWA), the clinical case definition of long COVID is still being developed, and “most Long COVID cases are diagnosed clinically, and no laboratory test can definitively distinguish Long COVID from other conditions with different etiologies”. The CDC recommended a “personal medical management plan” for symptom relief.   In July 2021, the Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice have joined together to issue the guidance for Long COVID to be categorized as a disability under the Americans with Disabilities Act (ADA), the Rehabilitation Act of 1973, and the Patient Protection and Affordable Care Act. The Guidance pointed out that Long Covid could lead to physical and mental impairments and limit one or more major life activities but noted that individual assessment is necessary to determine whether the conditions would qualify for disability.   Due to the wide varieties and ongoing nature of Long COVID symptoms, evidence-based diagnoses of Long COVID or post-COVID conditions are still under research. Characterization of post-COVID conditions, including risk factors, disproportionately affected populations, and health and financial burdens, and identification of successful interventions are still underway. From current data, Long COVID are found more often in people who had severe COVID-19 illness and those not vaccinated against the disease. The NYSIF also reported that the number of Long COVID claimants declined with increased vaccination rates. Ethnic minority groups and people with disabilities might also have higher risks of Long COVID due to their work or living condition. The NYSIF reported women worker Long COVID claimants are 11% higher than male workers.   HEALWA created a toolkit on the topic of COVID-19 at the onset of the pandemic that includes government and Open Access resources on COVID-19 information for our users. Tools within HEALWA such as DynaMed, CINAHL, and Clinical Key provide full-text articles on clinical cohort studies, including those on Long COVID diagnosis and treatment. With the ongoing research on post COVID conditions, we expect more cohort studies, patients tracking, medical chart analysis, and healthcare data to become available on our platform.   Reference:
  1. Centers for Disease Control and Prevention. (2020, February 11). Post-COVID Conditions: CDC Science—How CDC is using science to learn more about post-COVID conditions (or long COVID). COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-science.html
  2. Centers for Disease Control and Prevention. (2022, December 16). Long COVID or Post-COVID Conditions. COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
  3. DynaMed. (n.d.). Long COVID. COVID-19 (Novel Coronavirus). Retrieved January 24, 2023, from https://www.dynamed.com/condition/covid-19-novel-coronavirus#TOPIC_EQC_FQS_V4B
  4. National Center for Health Statistics. (2023, January 4). Household Pulse Survey. Long COVID. https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
  5. The New York State Insurance Fund. (2023). Shining a Light on Long Covid: An Analysis of Workers’ Compensation Data (p. 23). The New York State Insurance Fund. https://ww3.nysif.com/
  6. U.S. Department of Health and Human Services Office of Civil Rights. (2021, July 26). Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557 [Text]. HHS.Gov. https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html
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