Wisk Lauren E, L'Hommedieu Michelle, Diaz Roldan Kate, Ebna Mannan Imtiaz, Spatz Erica S, Weinstein Robert A, Venkatesh Arjun K, Gottlieb Michael, Huebinger Ryan, Rising Kristin L, Montoy Juan Carlos C, Stephens Kari A, Rodriguez Robert M, Hill Mandy J, O'Laughlin Kelli N, Gentile Nicole L, Idris Ahamed H, Li Shu-Xia, Santangelo Michelle, Kean Efrat R, McDonald Samuel A, Gatling Kristyn, Elmore Joann G
Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at the University of California, Los Angeles.
Codetta Bio Inc, Morrisville, North Carolina.
JAMA Netw Open. 2025 Aug 1;8(8):e2526506. doi: 10.1001/jamanetworkopen.2025.26506.
Long COVID definitions vary widely, and no consensus exists on how to accurately measure its prevalence, complicating both clinical care and research.
To assess long COVID prevalence using various definitions from published literature.
DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter cohort study used data from the longitudinal Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE). Participants aged 18 years or older with symptoms suggestive of COVID-19 illness at the time of their index SARS-CoV-2 test enrolled at 8 sites across the US from December 11, 2020, through August 29, 2022, with follow-up surveys collected through February 28, 2023.
Positive or negative SARS-CoV-2 test result at the time of acute symptoms.
Long COVID prevalence among INSPIRE participants with a positive vs negative index SARS-CoV-2 test, based on long COVID definitions in published literature. Secondary outcomes were sensitivity and specificity of published definitions compared with self-reported long COVID.
A total of 4575 INSPIRE participants were included (mean [SD] age, 40.40 [14.58] years). Most were female (3013 of 4448 [67.7%]) and aged 18 to 49 years (3338 of 4541 [73.5%]). Applying 5 published definitions for long COVID yielded a prevalence that ranged from 30.84% (95% CI, 29.33%-32.40%) to 42.01% (95% CI, 40.37%-43.66%) at 3 months and 14.23% (95% CI, 13.01%-15.55%) to 21.94% (95% CI, 20.47%-23.47%) at 6 months postinfection; in the 5 comparator studies, reported prevalence of long COVID at 1 to 5 months postinfection ranged from 2.6% (≥84 days) to 47.4% (3-5 months) and at 6 or more months postinfection ranged from 10.0% (95% CI, 8.8%-11.0%) to 61.9% (6-11 months). Using participants' self-reported long COVID as a criterion standard, existing published definitions had low-to-moderate sensitivity (up to 66.32% [95% CI, 62.59%-69.90%] at 3 months and 45.53% [95% CI, 41.51%-49.60%] at 6 months) and high specificity (up to 81.29% [95% CI, 79.32%-83.15%] at 3 months and 94.26% [95% CI, 92.98%-95.37%]) at 6 months.
In this cohort study, variability in long COVID prevalence across published definitions highlights the need for a standardized, validated definition to improve clinical recognition and research comparability, ultimately guiding more accurate diagnosis and treatment strategies.
“长期新冠”的定义差异很大，对于如何准确衡量其患病率尚无共识，这给临床护理和研究都带来了复杂性。
使用已发表文献中的各种定义评估“长期新冠”的患病率。
设计、背景和参与者：这项前瞻性、多中心队列研究使用了来自纵向的“新冠病毒感染患者创新支持登记处”（INSPIRE）的数据。2020年12月11日至2022年8月29日期间，年龄在18岁及以上、在首次进行新冠病毒检测时出现提示新冠疾病症状的参与者在美国8个地点入组，并在2023年2月28日前收集随访调查数据。
急性症状出现时新冠病毒检测呈阳性或阴性结果。
根据已发表文献中的“长期新冠”定义，比较INSPIRE参与者中首次新冠病毒检测呈阳性与阴性者的“长期新冠”患病率。次要结局是已发表定义与自我报告的“长期新冠”相比的敏感性和特异性。
共纳入4575名INSPIRE参与者（平均[标准差]年龄为40.40[14.58]岁）。大多数为女性（4448名中的3013名[67.7%]），年龄在18至49岁之间（4541名中的3338名[73.5%]）。应用5种已发表的“长期新冠”定义，感染后3个月时患病率范围为30.84%（95%置信区间，29.33%-32.40%）至42.01%（95%置信区间，40.37%-43.66%），6个月时为14.23%（95%置信区间，13.01%-15.55%）至21.94%（95%置信区间，20.47%-23.47%）；在5项对照研究中，报告的感染后1至5个月“长期新冠”患病率范围为2.6%（≥84天）至47.4%（3-5个月），感染后6个月及以上为10.0%（95%置信区间，8.8%-11.0%）至61.9%（6-11个月）。以参与者自我报告的“长期新冠”作为标准，现有已发表定义的敏感性低至中等（3个月时最高为66.32%[95%置信区间，62.59%-69.90%]，6个月时为45.53%[95%置信区间，41.51%-49.60%]），特异性高（3个月时最高为81.29%[95%置信区间，79.32%-83.15%]，6个月时为94.26%[95%置信区间，92.98%-95.37%]）。
在这项队列研究中，不同已发表定义的“长期新冠”患病率存在差异，这凸显了需要一个标准化、经过验证的定义，以提高临床识别和研究可比性，最终指导更准确的诊断和治疗策略。
