The 2024 NASEM definition describes Long Covid as “an infection-associated chronic condition that occurs after Covid-19 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems” (A Long Covid Definition: A Chronic, Systemic Disease State with Profound Consequences, NASEM, 2024).
NASEM outlines key points about the condition, including that it can range from mild to severe, affect any of the body’s organ systems, and begin either immediately after an acute Covid-19 infection or following a delay of weeks or months. Long Covid is diagnosed with a clinical assessment, either with or without a past positive Covid-19 test, because it has no known biomarker.
The definition provides explicit examples of common symptoms and requires them to last for at least 3 months before a diagnosis can be made. It also includes a statement on equity, highlighting that Long Covid can affect “children and adults, regardless of health, disability, or socioeconomic status, age, sex, gender, sexual orientation, race, ethnicity, or geographic location” to steer practitioners away from stereotypes that could impact diagnosis. Some data indicate that people in socioeconomically deprived settings face a higher risk of the condition.
One hope is that the definition will help shift the view of Long Covid to the medical condition it is, so that its symptoms are not viewed by providers, insurance companies, and the public as psychosomatic in nature, said Jacqueline Becker, PhD, a clinical neuropsychologist and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York, who is behind the recent effort to enhance Long Covid awareness, documentation, and screening among health care professionals.
“Long Covid is not a psychological condition,” Becker said. “It is a medical condition, and it should be treated as such.” Still, many patients report having their complaints dismissed in both medical and psychological clinical settings (Ireson, J., et al., Health Expectations, Vol. 25, No. 4, 2022).
[Related: Treating patients with long Covid]
Neuropsychologists work most frequently with Long Covid patients, but any psychology clinician may encounter the condition. Symptoms might show up in existing patients, or in new patients who are referred with or without a formal Long Covid diagnosis.
All psychologists should be screening for Long Covid, Becker said, especially because treating issues such as اكتئاب and anxiety will differ in patients with a chronic health condition and can further impact quality of life.
“Determining the onset of symptoms in relation to Covid-19 infection is really important,” she said. “Clinicians very simply need to ask the questions: When did this start? Have you ever had Covid-19, and when did it happen?”
While psychologists will not diagnose Long Covid themselves, they can confer directly with a patient’s primary care physician to establish a Long Covid diagnosis. It is important that psychologists include relevant International Classification of Diseases (ICD) codes to capture this secondary diagnosis when billing for services.
“For patients, the diagnosis provides an explanation of what’s going on,” said Laura Malone, MD, PhD, director of the Pediatric Post-Covid-19 Rehabilitation Clinic at Kennedy Krieger Institute in Baltimore, Maryland. “It also helps them get connected to specialty clinics that can provide the appropriate services they need.”
This article was written by from www.apa.org
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