Sick senior man sitting on the edge of his bed at the hospital while hospitalized – healthcare and medicine concepts

As COVID-19 continues to make its presence known, the world remains unclear about the sometimes-debilitating condition known as long COVID. There is no standardized definition and existing definitions have noted differences. Thus, experts are racing to establish optimal care models for those affected by long COVID.

This uncertainty prompted a recent scoping review that examined existing long COVID definitions, care approaches and optimal medical intervention. Among the review’s key insights: Researchers emphasized the need for a “standardized, valid, and reliable definition” to accurately identify people who could benefit from long COVID models of care.  At this point, however, there are six identified definitions, with five official definitions from governmental or nongovernmental organizations and one developed by a research consortium and based on a symptom score.

All definitions apply to adults and children and are consistent in describing persistent, recurring or new symptoms after acute COVID-19, which universally indicate multisystemic presentation, the review said. Symptom onset timing and minimum duration required for diagnosis vary across definitions, which prevent an optimal model of care, the reviewers explained.  

The review also found that, currently, long COVID care models share five essential principles: a core team with specialized expertise, access to a broad range of multidisciplinary services, comprehensive diagnostic and therapeutic resources, person-centered care and capacity to meet high demand.

The review identified 10 representative practice-based models, ranging from single-specialty clinics to advanced practice provider care and fully virtual clinics. Three systems-based models were also highlighted, including hub-and-spoke models, tiered care based on symptom severity, and centralized teleconsultation services for areas lacking specialized clinics.

And the review revealed that integrating long COVID management into primary care settings could increase capacity. This approach, however, requires training for healthcare providers, implementing guidelines and algorithms, and ensuring adequate specialist support and care coordination.

Although many care models have emerged, significant knowledge gaps remain, the reviewers emphasized. Further research is needed to establish a universal definition, evaluate the effectiveness of different models, develop strategies for underserved populations and ensure the sustainability of long COVID care over time.