(Plus a reminder from me about the possible benefit of Hyperbaric Oxygen Therapy)
To better understand and manage “long COVID”, physicians must first be able to define the condition. It’s been impossible to do that without consensus on the diagnosis. The National Academies of Sciences, Engineering, and Medicine (NASEM) recently moved to rectify that problem as a committee of experts created a consensus definition.
NASEM’s new definition states that “long COVID is an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.” The definition also comes with helpful parameters that cover five major areas.
According to NASEM, long COVID:
- Can follow SARS-CoV-2 infections of any severity, including those that are asymptomatic. Laboratory confirmation or other proof of initial SARS-CoV-2 infection is not required if it was not available.
- Must be present for at least three months.
- May accompany more than 200 symptoms and conditions, including the exacerbation of preexisting conditions. These can range from mild to severe.
- Can affect anyone, regardless of race, sex, gender, socioeconomic status, or other factors.
- Can profoundly affect a person’s ability to function and practice self-care.
The definition has implications for insurance coverage of therapies or treatments tied to long COVID.
The NASEM certainly did NOT discuss Hyperbaric Oxygen Therapy (HBOT) – so don’t misinterpret this reminder. I am mentioning the new official definition because there is anecdotal evidence that Hyperbaric Oxygen Therapy (HBOT) can improve the symptoms of long COVD. Clinicians who are willing to go to fight with a patient’s insurance to get HBOT covered by insurance may be able to use the NASEM criteria to both “diagnose” the condition and identify specific health outcomes they want to try to impact with HBOT.
In March of 2023, Dr. Sandra Wainwright gave a fantastic example of a practical approach to the use of HBOT for long COVID. She describes three patients and their symptoms and how she constructed her consultation notes to help make the case for HBOT. Clinicians can follow her approach but in addition, can now incorporate the NASEM definition and discuss how HBOT may help with specific symptoms.
The following resources support the use of HBOT from a pathophysiological standpoint (originally provided by Dr. Sandra Wainwright):
- Dr. Efrati et al, in their article published in Nature
- The UHMS position statement on COVID
- The review article published in UHM
- The article that I published in the UHM journal in which I discuss the ethics of using a safe “drug” like HBOT in a pandemic (Jansen D, Dickstein DR, Erazo K, Stacom E, Lee DC, Wainwright SK. Hyperbaric oxygen for COVID-19 patients with severe hypoxia prior to vaccine availability. Undersea Hyperb Med. 2022 Third Quarter;49(3):295-305. doi: 10.22462/05.06.2022.3. PMID: 36001562.)
–Caroline
Related posts:
- Helping Patients with Long COVID using Hyperbaric Oxygen Therapy (HBOT) – Caroline Fife M.D. (carolinefifemd.com)
- Hyperbaric Oxygen Therapy Improves Neurocognitive Functions and Symptoms of Post-COVID Condition – the Results of a Randomized Controlled Trial – Caroline Fife M.D. (carolinefifemd.com)
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
