Assessment of psychosocial aspects in adults in post-COVID-19 condition: the EURONET-SOMA recommendations on core outcome domains for clinical and research use.

Publication date: Feb 11, 2025

Harmonizing core outcome domains allows for pooling data, comparing interventions, and streamlining research evaluation. At the same time clinicians require concise and feasible measures for routine practice. Considering the heterogeneity of post-COVID-19 condition, a biopsychosocial approach requires sufficient coverage of the psychosocial dimension with assessments. Previous recommendations for core outcome sets have serious limitations regarding the psychosocial aspects of post-COVID-19 condition. This paper specifically focuses on psychosocial outcomes for adults with post-COVID-19 condition, providing both a comprehensive set of outcome domains for research and a streamlined clinical core set tailored for routine clinical use. In a structured Consensus Development Approach, the European Network to improve diagnostic, treatment, and healthcare for patients with persistent somatic symptoms (EURONET-SOMA) developed psychosocial core outcome domains and assessments regarding post-COVID-19 condition. The experts identified variables and instruments which should be considered in studies on adults suffering from post-COVID-19 condition, and which are feasible in the clinical setting and relevant for research. We identified three higher-order dimensions with each encompassing several domains: The first higher-order dimension, “outcomes”, encompasses (1) the classification/ diagnostics of post-COVID-19 condition, (2) somatic symptoms (including fatigue), (3) the psychopathological status and mental comorbidities, (4) the physical status and somatic comorbidities, (5) neurocognitive symptoms, and (6) illness consequences. The second higher-order domain “mechanisms” encompasses (7) cognitive components, (8) affective components, (9) behavioral components, (10) social components, and (11) psychobiological bridge markers (e. g., neuroimmunological and psychoneuroendocrinological variables). The third higher-order domain, “risk factors”, includes factors such as (12) socioeconomic status and sociocultural factors, (13) pre-existing mental and somatic health issues, (14) personality factors (e. g., neuroticism), (15) adverse childhood experiences, (16) ongoing disability or pension claim, and (17) social media use. For each domain, specific instruments are suggested for research purposes and clinical use. The recommended core domains help to increase consistency in a biopsychosocial approach to post-COVID-19 condition across investigations, improve synergies, and facilitate decision-making when comparing different interventional approaches. It allows to better identify relevant subgroups in heterogeneous post-COVID-19 condition populations offering practical tools for routine clinical practice through the clinical core set.

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Concepts Keywords
Clinicians Adult
Pooling Consensus
Psychoneuroendocrinological Core outcome domains
Streamlined COVID-19
EURONET-SOMA
Europe
Humans
Instruments
Post-Acute COVID-19 Syndrome
Post-COVID-19 condition
Post-COVID-19 syndrome
Psychosocial aspects
SARS-CoV-2

Semantics

Type Source Name
disease MESH COVID-19
disease MESH neuroticism
disease MESH adverse childhood experiences
drug DRUGBANK Tropicamide
disease MESH Long Covid
pathway REACTOME Reproduction
drug DRUGBANK Trestolone
drug DRUGBANK Etoperidone
disease MESH syndrome
disease MESH infection
disease MESH brain fog
disease MESH anxiety
disease MESH depression
disease IDO symptom
pathway REACTOME Translation
disease IDO quality
disease MESH chronic diseases
disease MESH cancer
disease MESH chronic pain
drug DRUGBANK Indoleacetic acid
disease MESH sequelae
disease IDO process
disease MESH symptom burden
disease MESH etiology
drug DRUGBANK Coenzyme M
disease MESH somatoform disorder
disease IDO acute infection
disease MESH myalgic encephalomyelitis
disease MESH Insomnia
disease MESH Psychological distress
disease MESH loneliness
disease MESH mood disorders
disease MESH affective symptoms
disease MESH Anxiety Disorder
disease MESH post traumatic stress disorder
drug DRUGBANK Gold
disease MESH mental disorders
disease IDO history
disease MESH Comorbidity
disease MESH attention deficit hyperactivity disorder
disease MESH Functional Status
drug DRUGBANK Spinosad
drug DRUGBANK Hydrocortisone
disease MESH inflammation
disease MESH educational level
disease IDO susceptibility
disease MESH obesity
disease MESH asthma
pathway KEGG Asthma
disease MESH chronic obstructive pulmonary disease
disease MESH ischemic heart disease
disease IDO role
disease IDO intervention
drug DRUGBANK Dimethyl sulfone
disease MESH Rare Diseases
disease MESH Spinal Diseases
drug DRUGBANK L-Citrulline
disease MESH Bodily Distress Disorder
disease MESH cognitive impairment
disease MESH Anomalies
drug DRUGBANK Copper
disease MESH morbidity
drug DRUGBANK (S)-Des-Me-Ampa
disease MESH hypochondriasis
disease MESH Arthritis
drug DRUGBANK Trihexyphenidyl
drug DRUGBANK Profenamine
disease MESH Acute Respiratory Distress Syndrome
disease MESH Low Back Pain
disease MESH Panic
disease IDO country
disease MESH Cardiovascular Disease
pathway REACTOME Immune System
disease IDO endotoxin
drug DRUGBANK Serotonin
disease MESH depressive disorders
drug DRUGBANK Elm
disease MESH death

Original Article

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