Long COVID-19 Neurological and Psychological Claims: Assessment Guidelines
Joseph Hirsch
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Steven Mandel
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Les Kertay
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James B. Talmage
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Greg Vanickachorn
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Kurt Hegmann
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James Underhill
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John Meyers
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Christopher R. Brigham
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Abstract

Post–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]) conditions are referred to by a wide range of names, including long COVID, post-acute COVID-19, long-term effects of COVID, post-acute COVID syndrome, chronic COVID, long-haul COVID, late sequelae, and others, as well as the research term, post-acute sequelae of SARS-CoV-2 infection (PASC). Symptoms may include difficulty thinking or concentrating, fatigue, depression, anxiety, and other complaints. The results of studies are clouded by self-reports, lack of objective cognitive data, misattribution, and ill-defined psychological issues. Prospective cohort studies with objective assessment are needed to clarify the impact of COVID-19. While we do not dismiss the presence of long COVID or chronic COVID-19 symptoms lasting beyond a typically expected viral respiratory-transmitted syndrome, neither do we uncritically accept such a syndrome in all those who were diagnosed as having COVID-19, especially in those whose initial presentation was asymptomatic or mild. Evaluators must be astute and perform unbiased, thorough assessments and focus on objective findings while carefully assessing the potential for confounding or alternate conditions.

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