A clinical case definition of post-COVID-19 condition by a Delphi consensus.
A clinical case definition of post-COVID-19 condition by a Delphi consensus.
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DOI：
10.1016/s1473-3099(21)00703-9
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发表时间：
2022-04
期刊：
影响因子：
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通讯作者：
WHO Clinical Case Definition Working Group on Post-COVID-19 Condition
中科院分区：
文献类型：
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作者：
Soriano JB;Murthy S;Marshall JC;Relan P;Diaz JV;WHO Clinical Case Definition Working Group on Post-COVID-19 Condition
COVID-19患者可能会出现持续的感染后后遗症。这种情况有多种名称，包括长期COVID或长途COVID，并自二零二零年九月起被列入ICD-10分类为COVID-19后状况，其表达及其影响各不相同。缺乏全球标准化和一致同意的定义阻碍了其流行病学特征和候选治疗方法的发展。在世卫组织领导的德尔菲过程中，我们与265名患者、临床医生、研究人员和世卫组织工作人员组成的国际小组合作，为这种疾病制定了一个共识定义。在两轮德尔菲过程中对14个领域和45个项目进行了评估，以创建针对成人的最终共识定义：COVID-19后病症发生在有可能或确诊的SARS-CoV-2感染史的个体中，通常在发病后3个月，症状持续至少2个月，并且无法通过替代诊断来解释。常见症状包括但不限于疲劳、呼吸急促和认知功能障碍，并且通常对日常功能产生影响。症状可能是从急性COVID-19发作中初步恢复后新发的，或从最初的疾病中持续存在。症状也可能随着时间的推移而波动或复发。单独的定义可能适用于儿童。虽然共识定义可能会随着知识的增加而改变，但这一共同框架为正在进行的和未来的流行病学、危险因素、临床特征和治疗研究提供了基础。
People with COVID-19 might have sustained postinfection sequelae. Known by a variety of names, including long COVID or long-haul COVID, and listed in the ICD-10 classification as post-COVID-19 condition since September, 2020, this occurrence is variable in its expression and its impact. The absence of a globally standardised and agreed-upon definition hampers progress in characterisation of its epidemiology and the development of candidate treatments. In a WHO-led Delphi process, we engaged with an international panel of 265 patients, clinicians, researchers, and WHO staff to develop a consensus definition for this condition. 14 domains and 45 items were evaluated in two rounds of the Delphi process to create a final consensus definition for adults: post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction, and generally have an impact on everyday functioning. Symptoms might be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms might also fluctuate or relapse over time. A separate definition might be applicable for children. Although the consensus definition is likely to change as knowledge increases, this common framework provides a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy.