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

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...

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Main Authors: Andrew G. Ewing, David Joffe, Svetlana Blitshteyn, Anna E. S. Brooks, Julien Wist, Yaneer Bar-Yam, Stephane Bilodeau, Jennifer Curtin, Rae Duncan, Mark Faghy, Leo Galland, Etheresia Pretorius, Spela Salamon, Danilo Buonsenso, Claire Hastie, Binita Kane, M. Asad Khan, Amos Lal, Dennis Lau, Raina MacIntyre, Sammie McFarland, Daniel Munblit, Jeremy Nicholson, Hanna M. Ollila, David Putrino, Alberto Rosario, Timothy Tan, The Long COVID consensus expert panel (Table S1)
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Annals of Clinical Microbiology and Antimicrobials
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Online Access:https://doi.org/10.1186/s12941-025-00793-9
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author Andrew G. Ewing
David Joffe
Svetlana Blitshteyn
Anna E. S. Brooks
Julien Wist
Yaneer Bar-Yam
Stephane Bilodeau
Jennifer Curtin
Rae Duncan
Mark Faghy
Leo Galland
Etheresia Pretorius
Spela Salamon
Danilo Buonsenso
Claire Hastie
Binita Kane
M. Asad Khan
Amos Lal
Dennis Lau
Raina MacIntyre
Sammie McFarland
Daniel Munblit
Jeremy Nicholson
Hanna M. Ollila
David Putrino
Alberto Rosario
Timothy Tan
The Long COVID consensus expert panel (Table S1)
author_facet Andrew G. Ewing
David Joffe
Svetlana Blitshteyn
Anna E. S. Brooks
Julien Wist
Yaneer Bar-Yam
Stephane Bilodeau
Jennifer Curtin
Rae Duncan
Mark Faghy
Leo Galland
Etheresia Pretorius
Spela Salamon
Danilo Buonsenso
Claire Hastie
Binita Kane
M. Asad Khan
Amos Lal
Dennis Lau
Raina MacIntyre
Sammie McFarland
Daniel Munblit
Jeremy Nicholson
Hanna M. Ollila
David Putrino
Alberto Rosario
Timothy Tan
The Long COVID consensus expert panel (Table S1)
author_sort Andrew G. Ewing
collection DOAJ
description 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.
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spelling doaj-art-01ba0165b23548b1bdcd524d8acdf9372025-08-20T04:01:52ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112025-04-0124111910.1186/s12941-025-00793-9Long COVID clinical evaluation, research and impact on society: a global expert consensusAndrew G. Ewing0David Joffe1Svetlana Blitshteyn2Anna E. S. Brooks3Julien Wist4Yaneer Bar-Yam5Stephane Bilodeau6Jennifer Curtin7Rae Duncan8Mark Faghy9Leo Galland10Etheresia Pretorius11Spela Salamon12Danilo Buonsenso13Claire Hastie14Binita Kane15M. Asad Khan16Amos Lal17Dennis Lau18Raina MacIntyre19Sammie McFarland20Daniel Munblit21Jeremy Nicholson22Hanna M. Ollila23David Putrino24Alberto Rosario25Timothy Tan26The Long COVID consensus expert panel (Table S1)Department of Chemistry and Molecular Biology, University of GothenburgWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupAustralian National Phenome Centre, Murdoch UniversityWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupDepartment of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCSFounding Member, Long Covid SupportWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupDivision of Pulmonary, Critical Care and Sleep Medicine, Mayo ClinicThe University of Adelaide and Royal Adelaide HospitalBiosecurity Program, Kirby Institute, University of New South WalesCEO & Founder Long Covid KidsImperial College and King’s CollegeAustralian National Phenome Centre, Murdoch UniversityInstitute for Molecular Medicine Finland, FIMM, HiLIFE, University of HelsinkiWorld Health Network Long Covid Expert Advisory GroupWorld Health Network Long Covid Expert Advisory GroupConsultant Cardiologist, Westmead and Blacktown HospitalsAbstract 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.https://doi.org/10.1186/s12941-025-00793-9Long COVIDDefinitionDiagnosisTreatmentResearchSocieties
spellingShingle Andrew G. Ewing
David Joffe
Svetlana Blitshteyn
Anna E. S. Brooks
Julien Wist
Yaneer Bar-Yam
Stephane Bilodeau
Jennifer Curtin
Rae Duncan
Mark Faghy
Leo Galland
Etheresia Pretorius
Spela Salamon
Danilo Buonsenso
Claire Hastie
Binita Kane
M. Asad Khan
Amos Lal
Dennis Lau
Raina MacIntyre
Sammie McFarland
Daniel Munblit
Jeremy Nicholson
Hanna M. Ollila
David Putrino
Alberto Rosario
Timothy Tan
The Long COVID consensus expert panel (Table S1)
Long COVID clinical evaluation, research and impact on society: a global expert consensus
Annals of Clinical Microbiology and Antimicrobials
Long COVID
Definition
Diagnosis
Treatment
Research
Societies
title Long COVID clinical evaluation, research and impact on society: a global expert consensus
title_full Long COVID clinical evaluation, research and impact on society: a global expert consensus
title_fullStr Long COVID clinical evaluation, research and impact on society: a global expert consensus
title_full_unstemmed Long COVID clinical evaluation, research and impact on society: a global expert consensus
title_short Long COVID clinical evaluation, research and impact on society: a global expert consensus
title_sort long covid clinical evaluation research and impact on society a global expert consensus
topic Long COVID
Definition
Diagnosis
Treatment
Research
Societies
url https://doi.org/10.1186/s12941-025-00793-9
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