Positive test not needed for long COVID diagnosis, experts conclude

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People do not need to have tested positive for the coronavirus to be considered for a diagnosis of long COVID, a new report from the National Academies of Sciences, Engineering and Medicine concludes.

The report, produced by a committee of experts at the request of the U.S. Social Security Administration, aims to summarize what is known about long COVID, a complex condition that was estimated to affect more than 9 million people in the United States in 2022.

Among its conclusions: Because testing has not always been available to people with COVID-19 — and because some who tested themselves at home never reported the results to healthcare systems — many who were infected never received formal documentation of their illness.

Some long COVID cases “have arisen from the early days of the epidemic, before testing was even generally available,” said Dr. Paul Volberding, professor emeritus of medicine at the University of California San Francisco, who served as chair of the committee. As the pandemic has evolved, some “people live in areas where they might not have easy access to tests.”

The report concluded that “sole reliance on a documented history of SARS-CoV-2 infection when diagnosing long COVID will miss these individuals,” so symptoms and “self-reported prior infection” are generally sufficient to establish that someone has been infected. As it stands, no diagnostic test for long COVID is available.

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