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. 2025 Dec;31(1):2535618.
doi: 10.1080/13814788.2025.2535618. Epub 2025 Sep 1.

Towards consensus: The need for standardised definitions in Long (post) COVID care in 34 European countries

Raquel Gomez-Bravo  1   2 , Sandra León-Herrera  3 , Marina Guisado-Clavero  4 , Ileana Gefaell  5   6 , Xenia Wostmann  7 , Nathalie Wössner  8 , Shlomo Vinker  9 , Francesca Vassallo La Ferla  10 , Erva Kırkoç Üçüncü  11 , Georgi Tsigarovski  12 , Péter Torzsa  13 , Kadri Suija  14   15 , Aleksander Stepanović  16 , Theresa Sentker  17 , Anna Segernäs  18 , Bohumil Seifert  19 , Marta Sánchez-Castro  20 , Jochen G Schneider  20 , Anna Repovská  7 , Ferdinando Petrazzuoli  21 , Davorina Petek  16 , Abel Perjes  13 , Naldy Parodi López  22   23 , Ana Luisa Neves  24   25 , Katarzyna Nessler  26 , Jean Muris  27 , Achim Mortsiefer  28 , Sarah Moreels  29 , Tatjana Meister  13 , Pekka Mäntyselkä  15 , Liubovė Murauskienė  30 , Heidrun Lingner  17 , Anna Krztoń-Królewiecka  31 , Milena Kostic  32 , Büsra Çimen Korkmaz  33 , Snezana Knezevic  34 , Stylianos Kazakos  35 , Vasilis Karathanos  36   37 , Ivanna Shushman  38 , Oksana Ilkov  39 , Kathryn Hoffmann  40 , Bruno Heleno  41   42 , Miroslav Hanževački  43   44 , Dragan Gjorgjievski  45 , Thomas Frese  46 , Marta Fournier  47   48 , Louise Fitzgerald  49   50 , Sabīne Feldmane  51 , Marina Dotsenko  52 , Philip-Richard Domeyer  53 , Daniel Croucher  54 , Vojtech Cerny  55 , Jako S Burgers  56 , Elena Brutskaya-Stempkovskaya  57 , Carmen Iliana Busneag  58   59 , Nicola Buono  60 , Sherihane Bensemmane  29 , Sabine Bayen  61 , Maria Bakola  62 , Radost Assenova  12 , Limor Adler  9 , Sara Ares-Blanco  63   64 , María Pilar Astier Peña  65   66
Affiliations

Towards consensus: The need for standardised definitions in Long (post) COVID care in 34 European countries

Raquel Gomez-Bravo et al. Eur J Gen Pract. 2025 Dec.

Abstract

Background: The COVID-19 pandemic has significantly impacted global healthcare systems, leading to challenges in managing Long COVID. Variations in definitions and diagnostic criteria across Europe hinder recognition and treatment efforts. This study aims to analyse and compare the definitions of Long COVID used in 34 European countries.

Methods: A retrospective descriptive study was conducted involving key informants from 34 European countries, utilising an online questionnaire to gather data on Long COVID definitions. Quantitative and qualitative analyses were employed to assess the variability of definitions and challenges in managing Long COVID.

Results: The study found significant variation in Long COVID definitions among the participating countries; the most frequent definition was the other definition (n: 17, 50.0%), followed by the World Health Organisation's definition (n: 16, 47.0%) and the CDC definition (n: 11, 32.3%). Half of the countries reported using multiple definitions simultaneously, indicating a lack of standardisation. Qualitative analyses highlighted challenges such as difficulties in standardising terminology, variability in clinical criteria, and issues with implementing diagnostic codes.

Conclusion: The findings underscore the need for a unified, yet adaptable, definition of Long COVID. Such a definition would support general practitioners (GPs) by simplifying diagnostic processes, improving continuity of care, and facilitating equitable patient access to multidisciplinary resources. The current lack of consensus complicates patient care, data collection, and resource allocation, impacting health policy development. Future efforts should focus on achieving agreement on definitions to ensure equitable treatment and effective healthcare responses to Long COVID.

Keywords: COVID-19; Europe; Primary health care; clinical coding; diagnosis; post-acute COVID-19 syndrome.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Consensus terms and definitions for Long COVID. NICE: National Institute for Health and Care Excellence; CDC: Centres for Disease Control and Prevention; ECDC: European Centre for Disease Prevention and Control; WHO: World Health Organisation; ICD-10: International Classification of Diseases-10; ESCMID: European Society of Clinical Microbiology and Infectious Diseases. Note: The official sources for the development of the survey can be found in Supplementary File 1.
Figure 2.
Figure 2.
Participating countries in the study and type of definition in each country.
See this image and copyright information in PMC

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