Identification and diagnosis of long COVID-19: A scoping review

Abstract

Long COVID-19 (LC-19) is a condition that has affected a high percentage of the population that recovered from the initial disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). LC-19 diagnosis is currently poorly defined because of its variable, multisystem, episodic symptoms, and lack of uniformity in the critical time points associated with the disease. Considering the number of cases, workers' compromised efficiency or inability to return to their duties can affect organizations and impact economies. LC-19 represents a significant burden on multiple levels and effectively reduces quality of life. These factors necessitate the establishment of firm parameters of diagnoses to provide a foundation for ongoing and future studies of clinical characteristics, epidemiology, risk factors, and therapy. In this scoping review, we conducted a literature search across multiple publication sites to identify papers of interest regarding the diagnosis of LC-19. We identified 225 records of interest and categorized them into seven categories. Based on our findings, there are only 11 original papers that outline the diagnostic process in detail with little overlap. This scoping review highlights the lack of consensus regarding the definition and, thereby, the LC-19 diagnosis processes. Due to no clear directive and considering the many unknowns surrounding the natural history of the disease and further recovery/sequelae from COVID-19, continued discussion and agreement on a definition/diagnosis will help future research and management of these patients.

Keywords: Diagnosis; Guidelines; Long COVID-19.

Fig. 1

Impact of Long COVID-19 at various levels to display the importance of early detection and minimize its impact. Created with BioRender.com.

Fig. 2

Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram pathway to filter records from database output for inclusion in our study.

Fig. 3

The distribution of papers based upon categories and geographic areas of publications. (a) Number of records based on the area of the paper (b) Papers detailing diagnostic guidelines (c) Papers on the symptoms of LC-19 (d) Distribution of papers discussing metabolic studies. Data points in groups are not exclusive.

Fig. 4

Schematic of LC-19 diagnosis based on the 11 papers that provided guidelines for the diagnosis pathway. Created with BioRender.com.

Fig. 5

Schematic representing potential confounding factors that delay or impact Long-COVID-19 diagnosis. Created with BioRender.com.