In a recent research letter published in the JAMA Network Open Journal, researchers assessed the published definitions of the post-coronavirus disease 2019 (COVID-19) condition.
Study: Definition of Post–COVID-19 Condition Among Published Research Studies. Image Credit: hoyaphoto/Shutterstock.com
Background
In February 2023, the global number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected cases reached around 759 million. Some people have reported ongoing symptoms like fatigue and breathlessness even after recovering from initial COVID-19.
The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and National Institute for Health and Care Excellence (NICE) have each released their definitions of the post-COVID-19 condition (PCC), with some variations between them.
The definition of lasting COVID-19 symptoms is not yet universally agreed on, despite the increasing research on the topic.
About the study
In the present study, researchers described the current definition of PCC as presented in existing studies.
According to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline, a descriptive study was conducted on the PCC definition.
The literature search was performed with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist within the PubMed database on 26 October 2022.
Between 1 February 2020 and 26 October 2022, approximately 7,087 studies included data on PCC. The publications were analyzed to extract the definition of PCC, the type of study, the country where the research was conducted, and the submission date of the manuscript. The information was presented in chronological order.
Two investigators conducted a review of studies and independently screened abstracts and titles. They also cross-verified a 10% sample of the collected data. Publication dates were employed to estimate the study time when the accurate submission dates were unavailable.
Results
Of 7,087 studies, 6,792 were deemed irrelevant to PCC and therefore excluded. The analysis included 295 studies comprising two randomized clinical trials, 66 cross-sectional studies, 134 cohort studies, 45 case series or case reports, 13 case-control studies, and 35 studies utilizing other designs.
Among these, 167 studies were carried out in European countries, while 102 studies utilized one of the three organizational definitions for their research.
Almost 193 papers did not adhere to any of the three PCC definitions, while six papers were submitted for publication before NICE's PCC definition was released. Of 193 papers that did not follow either of the three definitions, 129 employed their own PCC definitions, and 64 did not define PCC.
Conclusion
The study findings showed that most published studies did not adhere to the definitions of PCC from CDC, WHO, or NICE, resulting in significant heterogeneity in PCC definition.
Differences in definition pose a challenge when comparing interventions and outcomes between research that reported PCC.
The variations between findings can significantly impact the translation of results into clinical management and cost-effectiveness evaluations for interventions in PCC patients.
Effective clinical management of PCC requires a personalized approach based on evidence. The need for a clear definition of PCC is crucial to ensure that clinical trial evidence can be effectively applied to clinical management and ultimately improve the well-being of PCC patients.
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