Towards consensus: The need for standardised definitions in Long (post) COVID care in 34 European countries, 2025, Bravo et al.

Chandelier

Senior Member (Voting Rights)

Abstract​

Background​

The COVID-19 pandemic has significantly impacted global healthcare systems, leading to challenges in managing Long COVID. Variations in definitions and diagnostic criteria across Europe hinder recognition and treatment efforts. This study aims to analyse and compare the definitions of Long COVID used in 34 European countries.

Methods​

A retrospective descriptive study was conducted involving key informants from 34 European countries, utilising an online questionnaire to gather data on Long COVID definitions. Quantitative and qualitative analyses were employed to assess the variability of definitions and challenges in managing Long COVID.

Results​

The study found significant variation in Long COVID definitions among the participating countries; the most frequent definition was the other definition (n: 17, 50.0%), followed by the World Health Organisation’s definition (n: 16, 47.0%) and the CDC definition (n: 11, 32.3%). Half of the countries reported using multiple definitions simultaneously, indicating a lack of standardisation. Qualitative analyses highlighted challenges such as difficulties in standardising terminology, variability in clinical criteria, and issues with implementing diagnostic codes.

Conclusion​

The findings underscore the need for a unified, yet adaptable, definition of Long COVID. Such a definition would support general practitioners (GPs) by simplifying diagnostic processes, improving continuity of care, and facilitating equitable patient access to multidisciplinary resources. The current lack of consensus complicates patient care, data collection, and resource allocation, impacting health policy development. Future efforts should focus on achieving agreement on definitions to ensure equitable treatment and effective healthcare responses to Long COVID.
 
ORF.at wrote an article based on this study:

AI Summary: Long Covid – The Issue with the Definition

Introduction and Problem

In Austria, up to 850,000 people may have been affected by Long Covid. However, the exact cause of the ongoing symptoms remains unclear, and there is still no universally agreed-upon definition of Long Covid worldwide. This lack of clarity complicates both the diagnosis and treatment of affected individuals.

Different Definitions Across Europe
Experts from across Europe criticize the lack of standardized definitions and diagnostic criteria for Long Covid. This variety makes it harder to identify and treat patients effectively. General medicine plays a key role in the care of patients who suffer from various symptoms long after their acute Covid-19 infection. A survey of experts from 34 European countries revealed that the most commonly used definition of Long Covid is from the World Health Organization (WHO), followed by the definition from the Centers for Disease Control (CDC) in the US. About half of the countries use multiple definitions simultaneously.

Differences in Duration and Symptoms
The definitions also differ in terms of the duration of symptoms. The UK's NICE guidelines define Long Covid as symptoms lasting longer than twelve weeks, while the CDC and WHO refer to symptoms persisting for at least four or three months, respectively. All definitions emphasize the exclusion of other causes apart from SARS-CoV-2.

A “Patchwork Quilt” in Europe
Europe shows a "patchwork quilt" of definitions and diagnostic standards. For example, in Austria, the WHO, CDC, and NICE definitions are used, while other countries adopt different combinations of these definitions. This lack of uniformity not only affects diagnosis and treatment but also has an impact on research and resource allocation in health policy.

The Need for Consensus
Experts are calling for an international consensus to establish a universally accepted definition of Long Covid. A standardized definition would simplify diagnosis, improve continuity of care, and ensure equal access to multidisciplinary resources for patients. Currently, the absence of consensus complicates patient care, data collection, and the efficient allocation of resources.
 
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