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

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. 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. 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. 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.

COVID-19大流行已对全球医疗体系造成显著冲击，给长新冠（Long COVID）的管理带来诸多挑战。欧洲各国在长新冠的定义与诊断标准上存在差异，这阻碍了长新冠的识别与诊疗工作推进。本研究旨在分析并对比34个欧洲国家所采用的长新冠定义。本研究采用回顾性描述性研究设计，招募34个欧洲国家的关键信息提供者，通过在线问卷收集长新冠定义相关数据。研究采用定量与定性分析方法，评估长新冠定义的差异性以及长新冠管理中面临的各类挑战。研究结果显示，参与国的长新冠定义存在显著差异：最常见的为其他类定义（n=17，占比50.0%），其次为世界卫生组织（World Health Organisation, WHO）定义（n=16，占比47.0%）与美国疾病控制与预防中心（Centers for Disease Control and Prevention, CDC）定义（n=11，占比32.3%）。半数受访国家表示同时采用多种长新冠定义，反映出当前长新冠定义缺乏统一标准。定性分析凸显了多项核心挑战：包括术语标准化难度大、临床标准存在差异，以及诊断编码实施存在问题。研究结果强调，亟需制定统一且兼具适应性的长新冠定义。此类统一定义可简化全科医生（General Practitioners, GPs）的诊疗流程，提升医疗照护的连续性，并助力患者公平获取多学科医疗资源。当前长新冠定义缺乏共识的现状，加剧了患者诊疗、数据收集与资源分配的难度，对卫生政策制定造成负面影响。未来应致力于达成长新冠定义的统一共识，以确保患者获得公平诊疗，并为长新冠的医疗应对提供有效支撑。