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Review
. 2022 Apr;22(4):e102-e107.
doi: 10.1016/S1473-3099(21)00703-9. Epub 2021 Dec 21.

A clinical case definition of post-COVID-19 condition by a Delphi consensus

Joan B Soriano  1 , Srinivas Murthy  2 , John C Marshall  3 , Pryanka Relan  4 , Janet V Diaz  4 ; WHO Clinical Case Definition Working Group on Post-COVID-19 Condition
Affiliations
Review

A clinical case definition of post-COVID-19 condition by a Delphi consensus

Joan B Soriano et al. Lancet Infect Dis. 2022 Apr.

Abstract

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.

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Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

Figure 1
Figure 1
STROBE flowchart of participation in the two Delphi rounds
Figure 2
Figure 2
Distribution of participants worldwide Distribution of participants in May and June, 2021.
Figure 3
Figure 3
Domains that achieved consensus by participants in each Delphi stage
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