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Reaching Consensus on Long COVID Symptoms and Patient-Reported Outcomes Across the Veterans Health Administration

Amelia Schlak¹, Ilana Seidel^2,3, Omar Awan^4,5

¹Department of Veterans Affairs, Health System Research Portfolio, Office of Research and Development, Washington, DC.

|October 13, 2025

Summary

A consensus process established a standardized assessment for Long COVID symptoms in Veterans Health Administration (VHA) outpatient visits. This battery aids consistent tracking of long COVID conditions for improved veteran care.

Keywords:

SARS-CoV-2 infection (PASC)long COVID modified Delphi approach patient reported outcomes post-COVID-19 condition

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Area of Science:

Health Services Research
Clinical Assessment
Public Health

Background:

The Veterans Health Administration (VHA) lacked a standardized method for tracking Long COVID symptoms.
This deficiency impacted consistent patient monitoring and care delivery.

Purpose of the Study:

To achieve consensus among clinical stakeholders on assessing Long COVID symptoms during VHA outpatient visits.
To recommend a specific battery of instruments for Long COVID assessment.

Main Methods:

A hybrid Delphi-Nominal Group approach was employed.
Stakeholders included the VHA Long COVID Field Advisory Board (FAB), Community of Practice (CoP), and veteran input.
A literature review and clinician questionnaires identified 68 instruments, refined through multiple consensus rounds.

Main Results:

A final assessment battery was selected, including the Modified Yorkshire COVID-19 Rehabilitation Survey, VHA Whole Health Well-Being Signs, Exercise Vital Signs Questionnaire, and the 2-Minute Step Test.
Whole Health questions were integrated to align with the VHA's mission.
Existing VHA routine care instruments were excluded to avoid redundancy.

Conclusions:

A rapid, structured consensus process successfully identified a symptom instrument battery.
This battery aims to standardize Long COVID symptom assessment across VHA clinics.
The initiative supports improved management of Long COVID in the veteran population.