. 2025 Apr 20;24(1):27.

doi: 10.1186/s12941-025-00793-9.

Long COVID clinical evaluation, research and impact on society: a global expert consensus

Andrew G Ewing^{1

2}, David Joffe^{3

4

5}, Svetlana Blitshteyn^{3

6

7}, Anna E S Brooks^{3

8

9

10}, Julien Wist^{11

12

13}, Yaneer Bar-Yam^{3

14}, Stephane Bilodeau^{3

15}, Jennifer Curtin^{3

16}, Rae Duncan^{3

17}, Mark Faghy^{3

18}, Leo Galland^{3

19}, Etheresia Pretorius^{3

20

21}, Spela Salamon³, Danilo Buonsenso^{22

23}, Claire Hastie²⁴, Binita Kane^{3

25}, M Asad Khan^{3

26}, Amos Lal²⁷, Dennis Lau²⁸, Raina MacIntyre²⁹, Sammie McFarland³⁰, Daniel Munblit^{31

32}, Jeremy Nicholson^{33

34

12

35

36}, Hanna M Ollila^{37

38

39

40}, David Putrino^{3

41}, Alberto Rosario^{3

42}, Timothy Tan^{43

44

45

46}; Long COVID consensus expert panel (Table S1)

Collaborators, Affiliations

Collaborators

Long COVID consensus expert panel (Table S1):
Lawrence B Afrin, Carlos Arturo, Nisreen Alwan, Sampath Kumar, Harashen Ashraf, Veronica Athie Morales, Philip Atkinson, Robert Axtell, Cipatli Ayuzo, Alba Azola, James Bagley, Sergio Bagnato, Amitava Banerjee, John Barry, Daniela Bassi-Dibai, Anne Bheréur, Gregory Bix, Jose-Ramon Blanco, Svetlana Blitshteyn, Hector Bonilla, Angela Bowers, Anna E S Brooks, Marie Bruyneel, Alexandra Brugler Yonts, Gunnar Bücker, Kathleen Capaccione, Harriet Carroll, Pascal Cathebras, Ashish Chaudhry, Bela Cheda, Karin Chia, Pratima Chowdary, Tae Hwan Chung, Leslie Conner, Caterina Conte, Caroline Dalton, Kara Darling, Helen Davies, Kate Davies, David Davies-Payne, Kevin Deans, Luis Orantes Del Carpio, Anne Doherty, Theresa Dowell, Raechel A Evans, Andrew Ewing, Emilia Liana Falcone, Bingwen Eugene Fan, Emily Fatakhov, Kelly Fearnley, Artur Fedorowski, Carlo Ferrarese, Francesco Ferraro, Gemma Figtree, Laurie Findlay, Alberto Fortini, Matteo Foschi, Francois Gagnon, Nick Gall, Natasha Gerbis, Gholamrezanezhad Ali, Amine Ghram, Andréa Lúcia da Silva Goncalves, Helen Goss, Stephanie Grach, Caroline Gregoire, Gary Groot, Riccardo Guanà, Eric Guedj, Merel Hellemons, Melanie Hoppers, Mohammad-Salar Hosseini, Lee Ingle, Linn Jarte, Leslie Kasza, David Kaufman, Sundeep Kaul, Douglas Kell, Daphne Kemp, Robin Kerr, Abbas Khushnood, SangYun Kim, Cheryl Koh, Nik Kudiersky, Katharina Kurz, Gonzalo Labarca, Francisco Landi, Jaco Laubscher, Joshua Leisk, Jacob Leone, Graham Lloyd-Jones, C Raina MacIntyre, Kushal Madan, Stuart Malcolm, Harsha Master, Gez Medinger, Yolanda Meije, Alexios-Fotios Mentis, Francisco Mera-Cordero, David Miller, Bethan Myers, Hiten Naik, Javaid Nauman, Josef Niebauer, Estefania Nova-Lamperti, Maria Olivier, Otieno Martin Ong'wen, Rebecca Owen, Kelly O'Brien, Stefano Pallanti, Roger Paredes, Tina Peers, Alice Perlowski, Colin Pidgeon, Julianne Pitzele, Chris Ponting, Anna Porter, Amy Proal, Milo Puhan, Shaun Peter Qureshi, Sunil Raina, Nandini Raj, Ashwin Rajenesh, Clare Rayner, Alfonso J Rodriguez-Morales, Luca Roncati, Cilla Rosen, Ilene Ruhoy, Leslie Rydberg, Špela Šalamon, Carmen Scheibenbogen, Sarah Schenck, Katharine Seagly, Jaffer Shah, Ben Sinclair, Ioakim Spyridopoulos, Warren Tate, Claire Taylor, Catherine Tewolde, Alain Thierry, Callum Thomas, Tracey Thompson, Irene Tosetti, Eleonora Trecca, Jordan Vaughn, Chantelle Venter, Amber Vermeesch, Joe Vipond, Guiulia Vivaldi, Maxine Waters, William Weir, Emma Weisblatt, May Wong, Rob Wüst, Azfar Zaman, James Zhang

Affiliations

¹ Department of Chemistry and Molecular Biology, University of Gothenburg, Gothenburg, Sweden. Andrewe@chem.gu.se.
² World Health Network Long Covid Expert Advisory Group, Cambridge, USA, MA. Andrewe@chem.gu.se.
³ World Health Network Long Covid Expert Advisory Group, Cambridge, USA, MA.
⁴ Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, Australia.
⁵ Woolcock Institute of Medical Research (Sleep Group), Sydney, Australia.
⁶ Department of Neurology, University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA.
⁷ Dysautonomia Clinic, Williamsville, NY, USA.
⁸ Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁹ School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand.
¹⁰ The Maurice Wilkins Centre, Auckland, New Zealand.
¹¹ Australian National Phenome Centre, Murdoch University, Murdoch, Australia.
¹² Imperial College London, London, UK.
¹³ Chemistry Department, Universidad del Valle, Cali, Colombia.
¹⁴ New England Complex Systems Institute, Cambridge, MA, USA.
¹⁵ Department of Bioengineering, McGill University, Montreal, Canada.
¹⁶ Real Time Health Monitoring, San Francisco, CA, USA.
¹⁷ The Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
¹⁸ Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK.
¹⁹ Foundation for Integrated Medicine, New York, NY, USA.
²⁰ Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
²¹ Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
²² Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
²³ Area Pediatrica, Dipartimento di Scienza Della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
²⁴ Founding Member, Long Covid Support, London, UK.
²⁵ Manchester University Foundation Trust, School for Biological Sciences, University of Manchester, Manchester, UK.
²⁶ Directorate of Respiratory Medicine, Manchester University Hospitals, North West Lung Centre, Manchester, M23 9LT, UK.
²⁷ Division of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, MN, USA.
²⁸ The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.
²⁹ Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, Australia.
³⁰ CEO & Founder Long Covid Kids, London, UK.
³¹ Imperial College and King's College, London, UK.
³² Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
³³ Australian National Phenome Centre, Murdoch University, Perth, WA, Australia.
³⁴ Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.
³⁵ Nanyang Technological University, Singapore, Singapore.
³⁶ Regional Adjunct Professor, Khon Kaen University, Khon Kaen, Thailand.
³⁷ Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland.
³⁸ Broad Institute of Harvard and MIT and Center of Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
³⁹ Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
⁴⁰ Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴¹ Cohen Center for Recovery From Complex Chronic Illness, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴² Infection Prevention Team, World Health Network, Cambridge, MA, USA.
⁴³ Consultant Cardiologist, Westmead and Blacktown Hospitals, Sydney, Australia.
⁴⁴ Conjoint Professor, School of Medicine, Western Sydney University, Sydney, Australia.
⁴⁵ Conjoint Clinical Associate Professor Sydney Medical School, Sydney University, Sydney, Australia.
⁴⁶ Adjunct Associate Professor, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia.

PMID: 40254579
PMCID: PMC12010688
DOI: 10.1186/s12941-025-00793-9

Long COVID clinical evaluation, research and impact on society: a global expert consensus

Andrew G Ewing et al. Ann Clin Microbiol Antimicrob. 2025.

. 2025 Apr 20;24(1):27.

doi: 10.1186/s12941-025-00793-9.

Authors

Collaborators

Long COVID consensus expert panel (Table S1):
Lawrence B Afrin, Carlos Arturo, Nisreen Alwan, Sampath Kumar, Harashen Ashraf, Veronica Athie Morales, Philip Atkinson, Robert Axtell, Cipatli Ayuzo, Alba Azola, James Bagley, Sergio Bagnato, Amitava Banerjee, John Barry, Daniela Bassi-Dibai, Anne Bheréur, Gregory Bix, Jose-Ramon Blanco, Svetlana Blitshteyn, Hector Bonilla, Angela Bowers, Anna E S Brooks, Marie Bruyneel, Alexandra Brugler Yonts, Gunnar Bücker, Kathleen Capaccione, Harriet Carroll, Pascal Cathebras, Ashish Chaudhry, Bela Cheda, Karin Chia, Pratima Chowdary, Tae Hwan Chung, Leslie Conner, Caterina Conte, Caroline Dalton, Kara Darling, Helen Davies, Kate Davies, David Davies-Payne, Kevin Deans, Luis Orantes Del Carpio, Anne Doherty, Theresa Dowell, Raechel A Evans, Andrew Ewing, Emilia Liana Falcone, Bingwen Eugene Fan, Emily Fatakhov, Kelly Fearnley, Artur Fedorowski, Carlo Ferrarese, Francesco Ferraro, Gemma Figtree, Laurie Findlay, Alberto Fortini, Matteo Foschi, Francois Gagnon, Nick Gall, Natasha Gerbis, Gholamrezanezhad Ali, Amine Ghram, Andréa Lúcia da Silva Goncalves, Helen Goss, Stephanie Grach, Caroline Gregoire, Gary Groot, Riccardo Guanà, Eric Guedj, Merel Hellemons, Melanie Hoppers, Mohammad-Salar Hosseini, Lee Ingle, Linn Jarte, Leslie Kasza, David Kaufman, Sundeep Kaul, Douglas Kell, Daphne Kemp, Robin Kerr, Abbas Khushnood, SangYun Kim, Cheryl Koh, Nik Kudiersky, Katharina Kurz, Gonzalo Labarca, Francisco Landi, Jaco Laubscher, Joshua Leisk, Jacob Leone, Graham Lloyd-Jones, C Raina MacIntyre, Kushal Madan, Stuart Malcolm, Harsha Master, Gez Medinger, Yolanda Meije, Alexios-Fotios Mentis, Francisco Mera-Cordero, David Miller, Bethan Myers, Hiten Naik, Javaid Nauman, Josef Niebauer, Estefania Nova-Lamperti, Maria Olivier, Otieno Martin Ong'wen, Rebecca Owen, Kelly O'Brien, Stefano Pallanti, Roger Paredes, Tina Peers, Alice Perlowski, Colin Pidgeon, Julianne Pitzele, Chris Ponting, Anna Porter, Amy Proal, Milo Puhan, Shaun Peter Qureshi, Sunil Raina, Nandini Raj, Ashwin Rajenesh, Clare Rayner, Alfonso J Rodriguez-Morales, Luca Roncati, Cilla Rosen, Ilene Ruhoy, Leslie Rydberg, Špela Šalamon, Carmen Scheibenbogen, Sarah Schenck, Katharine Seagly, Jaffer Shah, Ben Sinclair, Ioakim Spyridopoulos, Warren Tate, Claire Taylor, Catherine Tewolde, Alain Thierry, Callum Thomas, Tracey Thompson, Irene Tosetti, Eleonora Trecca, Jordan Vaughn, Chantelle Venter, Amber Vermeesch, Joe Vipond, Guiulia Vivaldi, Maxine Waters, William Weir, Emma Weisblatt, May Wong, Rob Wüst, Azfar Zaman, James Zhang

Affiliations

¹ Department of Chemistry and Molecular Biology, University of Gothenburg, Gothenburg, Sweden. Andrewe@chem.gu.se.
² World Health Network Long Covid Expert Advisory Group, Cambridge, USA, MA. Andrewe@chem.gu.se.
³ World Health Network Long Covid Expert Advisory Group, Cambridge, USA, MA.
⁴ Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, Australia.
⁵ Woolcock Institute of Medical Research (Sleep Group), Sydney, Australia.
⁶ Department of Neurology, University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA.
⁷ Dysautonomia Clinic, Williamsville, NY, USA.
⁸ Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁹ School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand.
¹⁰ The Maurice Wilkins Centre, Auckland, New Zealand.
¹¹ Australian National Phenome Centre, Murdoch University, Murdoch, Australia.
¹² Imperial College London, London, UK.
¹³ Chemistry Department, Universidad del Valle, Cali, Colombia.
¹⁴ New England Complex Systems Institute, Cambridge, MA, USA.
¹⁵ Department of Bioengineering, McGill University, Montreal, Canada.
¹⁶ Real Time Health Monitoring, San Francisco, CA, USA.
¹⁷ The Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
¹⁸ Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK.
¹⁹ Foundation for Integrated Medicine, New York, NY, USA.
²⁰ Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
²¹ Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
²² Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
²³ Area Pediatrica, Dipartimento di Scienza Della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
²⁴ Founding Member, Long Covid Support, London, UK.
²⁵ Manchester University Foundation Trust, School for Biological Sciences, University of Manchester, Manchester, UK.
²⁶ Directorate of Respiratory Medicine, Manchester University Hospitals, North West Lung Centre, Manchester, M23 9LT, UK.
²⁷ Division of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, MN, USA.
²⁸ The University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.
²⁹ Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, Australia.
³⁰ CEO & Founder Long Covid Kids, London, UK.
³¹ Imperial College and King's College, London, UK.
³² Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
³³ Australian National Phenome Centre, Murdoch University, Perth, WA, Australia.
³⁴ Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia.
³⁵ Nanyang Technological University, Singapore, Singapore.
³⁶ Regional Adjunct Professor, Khon Kaen University, Khon Kaen, Thailand.
³⁷ Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Helsinki, Finland.
³⁸ Broad Institute of Harvard and MIT and Center of Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
³⁹ Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
⁴⁰ Centre for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴¹ Cohen Center for Recovery From Complex Chronic Illness, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴² Infection Prevention Team, World Health Network, Cambridge, MA, USA.
⁴³ Consultant Cardiologist, Westmead and Blacktown Hospitals, Sydney, Australia.
⁴⁴ Conjoint Professor, School of Medicine, Western Sydney University, Sydney, Australia.
⁴⁵ Conjoint Clinical Associate Professor Sydney Medical School, Sydney University, Sydney, Australia.
⁴⁶ Adjunct Associate Professor, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia.

PMID: 40254579
PMCID: PMC12010688
DOI: 10.1186/s12941-025-00793-9

Erratum in

Correction: Long COVID clinical evaluation, research and impact on society: a global expert consensus.
Ewing AG, Joffe D, Blitshteyn S, Brooks AES, Wist J, Bar-Yam Y, Bilodeau S, Curtin J, Duncan R, Faghy M, Galland L, Pretorius E, Salamon S, Buonsenso D, Hastie C, Kane B, Khan MA, Lal A, Lau D, MacIntyre R, McFarland S, Munblit D, Nicholson J, Ollila HM, Putrino D, Rosario A, Tan T; Long COVID consensus expert panel (Table S1). Ewing AG, et al. Ann Clin Microbiol Antimicrob. 2025 Jul 10;24(1):41. doi: 10.1186/s12941-025-00803-w. Ann Clin Microbiol Antimicrob. 2025. PMID: 40640905 Free PMC article. No abstract available.

Abstract

Background: Long COVID is a complex, heterogeneous syndrome affecting over four hundred million people globally. There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed. The goal of this work is to disseminate essential information about Long COVID and recommendations about definition, diagnosis, treatment, research and social issues to physicians, researchers, and policy makers to address this escalating global health crisis.

Methods: A 3-round modified Delphi consensus methodology was distributed internationally to 179 healthcare professionals, researchers, and persons with lived experience of Long COVID in 28 countries. Statements were combined into specific areas: definition, diagnosis, treatment, research, and society.

Results: The survey resulted in 187 comprehensive statements reaching consensus with the strongest areas being diagnosis and clinical assessment, and general research. We establish conditions for diagnosis of different subgroups within the Long COVID umbrella. Clear consensus was reached that the impacts of COVID-19 infection on children should be a research priority, and additionally on the need to determine the effects of Long COVID on societies and economies. The consensus on COVID and Long COVID is that it affects the nervous system and other organs and is not likely to be observed with initial symptoms. We note, biomarkers are critically needed to address these issues.

Conclusions: This work forms initial guidance to address the spectrum of Long COVID as a disease and reinforces the need for translational research and large-scale treatment trials for treatment protocols.

Keywords: Definition; Diagnosis; Long COVID; Research; Societies; Treatment.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The WCG IRB reviewed and approved this study (IRB Tracking Number: 20234854). After confirming they understood the study requirements, all participants provided written consent in English via the survey platform (Online Encrypted Google Forms). Only 3 assigned persons had access to the dataset, and the Delphi study executive committee members were the final ones responsible for deciding to submit it for publication. Consent for publication: Not applicable. Competing interests: Etheresia Pretorius has filed various patents related to methods for the early detection of inflammatory disease risk. She has also filed a patent for a novel method for the diagnosis of coagulation pathology in Long COVID. All other authors state no competing of interest.

Figures

**Fig. 1**
Breakdown of Long COVID consensus expert panel giving areas of expertise, age range, gender pattern, and countries

**Fig. 2**
Design of the 3-stage modified Delphi survey. A total of 179 experts participated over the three stages. A total of 1574 experts from searching the literature were initially contacted and 32 gave responses to an open-ended set of questions (see Table S4). In the Delphi rounds, the response rate to the first round of 132 statements was 46% and the response rate to the second round of 105 statements was 49%

**Fig. 3**
Summary of consensus statements by topic and consensus level (listed in Table 1)

See this image and copyright information in PMC

References

1. WHO. Number of COVID-19 cases reported to WHO: WHO COVID-19 dashboard, https://data.who.int/dashboards/covid19/cases?n=c. Last accessed April 13, 2025.
1. Kuang S, Earl S, Clarke J, Zakaria D, Demers A. Experiences of Canadians with long-term symptoms following COVID-19. Report No. 2291–0840, 2023.
1. Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med. 2022;28:2398–405. 10.1038/s41591-022-02051-3. - PMC - PubMed
1. Dashboards NC. Dashboard: Long COVID: demographics of diagnosed long COVID patients (U09.9). https://covid.cd2h.org/dashboard/public-health/long-covid/13. Last accessed April 13, 2025.
1. Dennis A, Wamil M, Alberts J, Oben J, Cuthbertson DJ, Wootton D, Crooks M, Gabbay M, Brady M, Hishmeh L, Attree E, Heightman M, Banerjee R, Banerjee A, COVERSCAN study investigators. Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study. BMJ Open. 2021;11: e048391. 10.1136/bmjopen-2020-048391. - PMC - PubMed

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Long COVID clinical evaluation, research and impact on society: a global expert consensus

Collaborators

Affiliations

Long COVID clinical evaluation, research and impact on society: a global expert consensus

Authors

Collaborators

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical