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Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification

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  • César Fernández-de-las-Peñas

    (Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain)

  • Domingo Palacios-Ceña

    (Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain)

  • Víctor Gómez-Mayordomo

    (Department of Neurology, Hospital Clínico San Carlos, 28040 Madrid, Spain)

  • María L. Cuadrado

    (Department of Neurology, Hospital Clínico San Carlos, 28040 Madrid, Spain
    Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain)

  • Lidiane L. Florencio

    (Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), 28922 Madrid, Spain)

Abstract

The pandemic of the coronavirus disease 2019 (COVID-19) has provoked a second pandemic, the “long-haulers”, i.e., individuals presenting with post-COVID symptoms. We propose that to determine the presence of post-COVID symptoms, symptoms should appear after the diagnosis of SARS-CoV-2 infection; however, this situation has some problems due to the fact that not all people infected by SARS-CoV-2 receive such diagnosis. Based on relapsing/remitting nature of post-COVID symptoms, the following integrative classification is proposed: potentially infection related-symptoms (up to 4–5 weeks), acute post-COVID symptoms (from week 5 to week 12), long post-COVID symptoms (from week 12 to week 24), and persistent post-COVID symptoms (lasting more than 24 weeks). The most important topic is to establish the time reference points. The classification also integrates predisposing intrinsic and extrinsic factors and hospitalization data which could promote post-COVID symptoms. The plethora of symptoms affecting multiple systems exhibited by “long-haulers” suggests the presence of different underlying mechanisms.

Suggested Citation

  • César Fernández-de-las-Peñas & Domingo Palacios-Ceña & Víctor Gómez-Mayordomo & María L. Cuadrado & Lidiane L. Florencio, 2021. "Defining Post-COVID Symptoms (Post-Acute COVID, Long COVID, Persistent Post-COVID): An Integrative Classification," IJERPH, MDPI, vol. 18(5), pages 1-9, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2621-:d:511395
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    References listed on IDEAS

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    1. Nicola Magnavita & Paolo Maurizio Soave & Walter Ricciardi & Massimo Antonelli, 2020. "Occupational Stress and Mental Health among Anesthetists during the COVID-19 Pandemic," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
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    2. David Monier & Paul Bonjean & Pierre Carcasset & Martine Moulin & Bruno Pozzetto & Elisabeth Botelho-Nevers & Luc Fontana & Carole Pelissier, 2023. "Factors Contributing to Delayed Return to Work among French Healthcare Professionals Afflicted by COVID-19 at a Hospital in the Rhône-Alpes Region, 2021," IJERPH, MDPI, vol. 20(21), pages 1-8, October.
    3. Sally Fowler-Davis & Rachel Young & Tom Maden-Wilkinson & Waqas Hameed & Elizabeth Dracas & Eleanor Hurrell & Romila Bahl & Elisabeth Kilcourse & Rebecca Robinson & Robert Copeland, 2021. "Assessing the Acceptability of a Co-Produced Long COVID Intervention in an Underserved Community in the UK," IJERPH, MDPI, vol. 18(24), pages 1-16, December.
    4. Ewa Małgorzata Szepietowska & Ewa Zawadzka & Sara Filipiak, 2022. "Symptoms of Post-Traumatic Stress Disorder and the Sense of Gains and Losses during the COVID-19 Pandemic: An International Study," IJERPH, MDPI, vol. 19(6), pages 1-19, March.
    5. Alicja Mińko & Agnieszka Turoń-Skrzypińska & Aleksandra Rył & Natalia Tomska & Zuzanna Bereda & Iwona Rotter, 2022. "Searching for Factors Influencing the Severity of the Symptoms of Long COVID," IJERPH, MDPI, vol. 19(13), pages 1-11, June.
    6. Marco Tofani & Anna Berardi & Maurizio Marceca & Donatella Valente & Alfonso Mazzaccara & Antonella Polimeni & Giovanni Galeoto, 2021. "Fighting COVID-19 Contagion among University Students of Healthcare Professions: An Italian Cross-Sectional Study," IJERPH, MDPI, vol. 18(23), pages 1-9, December.
    7. Daniel de Macêdo Rocha & Andrey Oeiras Pedroso & Laelson Rochelle Milanês Sousa & Elucir Gir & Renata Karina Reis, 2025. "Predictors for Anxiety and Stress in Long COVID: A Study in the Brazilian Population," IJERPH, MDPI, vol. 22(2), pages 1-12, February.
    8. Yulu Zhao & Xinye Xu & Gangwei Cai & Zhetao Hu & Yan Hong, 2022. "Promoting Strategies for Healthy Environments in University Halls of Residence under Regular Epidemic Prevention and Control: An Importance—Performance Analysis from Zhejiang, China," IJERPH, MDPI, vol. 19(23), pages 1-19, November.
    9. Domingo Palacios-Ceña & César Fernández-de-las-Peñas & Lidiane L. Florencio & María Palacios-Ceña & Ana I. de-la-Llave-Rincón, 2021. "Future Challenges for Physical Therapy during and after the COVID-19 Pandemic: A Qualitative Study on the Experience of Physical Therapists in Spain," IJERPH, MDPI, vol. 18(16), pages 1-14, August.
    10. Leoni-Johanna Speichert & Adam Schweda & Oliver Witzke & Margarethe Konik & Hana Rohn & Mark Stettner & Venja Musche & Klaas Herchert & Madeleine Fink & Sheila Geiger & Alexander Bäuerle & Eva-Maria S, 2022. "Fear of Death during COVID-19 Does Not Explain Post-Infection Depression Symptoms beyond Reported Symptoms during the Infection in COVID-19 Survivors," IJERPH, MDPI, vol. 19(21), pages 1-10, October.

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